Episode Transcript
[00:00:00] Speaker A: This podcast is brought to you by MHA of Dutchess county and produced by CMJW Entertainment.
This episode of the Vital Women Podcast is proudly sponsored by Salt Boutique Labs.
You're listening to the Vital Women Podcast.
[00:00:18] Speaker B: Welcome back to the Vital Women. I am your host, Yvette O'. Sullivan. Today, the 2026 Winter Olympics are in full swing in Italy. And while we see the glamour of the ice, we rarely see the high stakes medical battles happening behind the scenes. Joining us today is Dr. Tracy Espiritu McKay. She is a team precision for US figure skating currently on the ground, helping our athletes navigate the 2026 Winter Games. As a physiatrist and clinical assistant Assistant professor at NYU Grossman School of Medicine, Dr. McKay is a leading expert in rehabilitation and medicine.
That's a mouthful.
[00:00:56] Speaker C: Well, thank you for the introduction.
[00:00:58] Speaker B: Well, welcome to the Vital Women. We're so happy to have you. Let me finish the rest of your introduction because I want our audience to know exactly what you do as a physiatrist. So Dr. McKay is a leading expert in rehabilitation medicine. She's also the chair, Performing Arts Medicine, Community of American Physical Medicine and Rehabilitation. And she is off the trails and running to help us today unpack what it is to be a physiologist.
Did I say that correctly?
[00:01:29] Speaker C: Physiatrist.
[00:01:30] Speaker B: Physiatrist. My goodness. I'm stumbling in my words here because I've never heard what a physiatrist is all about. So I'm excited to learn what that is today.
[00:01:38] Speaker C: Yes, thank you for having me. So I guess a brief general introduction about physiatrists are that we like to go by PM and R doctors.
We are physicians that focus on neurological musculoskeletal conditions.
And we really treat the patient and the person as a whole. We really fun. Sorry. We really focus on function. You're not the only one having issues with birds today.
And we like to get our patients back to what they love doing. We really focus on their day to day activities, how they function in society and really how they function in their own personal world. We treat them as a person.
[00:02:13] Speaker B: I love watching figure skating. That is like my favorite part of the Winter Olympics because it's such a beautiful art dance and just everything that the athletes put into it. But one of the things that I've noticed is, you know, when they're landing on their feet and it seems like they're putting like five to eight pounds on their body pressure and during this time I wonder, are they hiding certain Injuries that maybe are happening during their doing these jumps. What do you do in case something like this happens? Like, what are you thinking? Are you thinking the same thing I'm thinking while you're watching them?
[00:02:46] Speaker C: I mean, sometimes they actually are hiding injuries, and they're often pushing through these injuries because they have to.
You know, it's the physician's role to really determine if continuing to skate through these injuries is safe to do. But the vast majority of the injuries that these skaters. Well, I'm going to talk about figure skating, since I care for them predominantly.
They are not necessarily trauma related.
They're usually due to overuse. So, I mean, they've got their full body weight landing on these knives, on their feet. The surface area is so incredibly small.
So they're often getting, you know, overuse injuries, stress fractures in their feet, in their legs. And if they're not caring for them adequately, they can really lead to some awful injuries down the line. So to answer your question, yes, sometimes they. They are hiding some injuries, but, you know, most often, if it hurts too much to skate, they're just often smart enough to stop. Yeah.
[00:03:43] Speaker A: So what does the overtraining look like necessarily? And when do you have to, like, step in to have that kind of intervention?
[00:03:50] Speaker C: You know, you have to be really attuned to what these skaters are going through. And the physicians and the athletic trainers and the physical therapists are not on the ice with them day to day. Usually it's really the coaches that are frontline. So some of the earliest signs are fatigue, an inability to recover, kind of just not performing at the level that they're used to.
And then later on, it's just an inability to recover. So it's usually due to imbalance, where they are training repeatedly more than they should. They're not getting enough rest, they're not getting the nutrition they need. It's usually just a really poor imbalance of kind of what they're doing day in and day out.
[00:04:26] Speaker B: So how do they handle that recovery period? Let's say, when they're traveling and they went from the Netherlands to Italy within 48 hours, do they recuperate so quickly to perform?
[00:04:39] Speaker C: That's tough. I mean, thankfully, the skaters that were in the Netherlands did not travel to Milan. They like to delegate which skaters go to each competition. Because we keep this in mind. We want to make sure that our skaters are healthy and not fatigued and not at risk of really hurting themselves.
So. But that being said, there are always competitions back to back that sometimes they have to be at we encourage our skaters to think about what they're doing day to day. If they skated heavy one day, maybe take a rest day, or if they don't entirely want to rest, maybe do some weight training or light yoga, just some, maybe stretching exercises that keep them limber. But really, part of what we encourage is cross training so that they're not overusing certain muscle groups that they might use when they're skating on the ice all the time.
[00:05:29] Speaker A: One thing I was just going to ask was, I was just curious how you got involved with. Specifically with the figure skating team and how long you've been doing it necessarily, because obviously this has been a big year as it is. We already have one medal. We have. I'm probably going to butcher the name Ilya Melanin, who got, I believe, gold. Right? So that's fantastic. This is a big year. But what did it look like before this year for you? How'd you get started in this?
[00:05:53] Speaker C: So, actually, my background is predominantly in treating Broadway performers and performing artists, really.
So it was like a. It was a nice segue to kind of get me to treating athletes who perform musically and artistically on the ice.
I did cover some regional events in the New York City area for our local skating club. And I applied, I sent in my cv, much like any other job application. They reviewed it, and thankfully, they said with my experience with artists and performing artists, it really kind of appealed to the US Figure skating team.
So this is actually my first year working with them internationally and more on the broader stage, the world stage, I guess.
And it's really been incredible. It's been an awesome experience so far.
[00:06:40] Speaker A: What would you say are the similarities between the dancers and the skaters when it comes to the training and the ways that you have to take care of each one of them?
[00:06:49] Speaker C: Actually, it's very similar. So, like I said before, a lot of their injuries are mostly overuse rather than trauma. I mean, the difference is, of course, you've got knives on your feet, there are other skaters around you, there are collisions. The treatment is a little bit different and how they acquire some of their injuries. But again, for the performing artists, for the skaters, it's all about cross training. For all of the athletes, in fact, whether you're in Winter Olympics, Summer Olympics, you want to make sure that these athletes are doing activities that are more than just their usual sport, because overuse and fatigue is a real thing.
[00:07:24] Speaker A: Without a doubt. I was just speaking with us, I mean, not figure skaters. Speed skater Clayton D. Clementi, who. He's been doing the thousand meter and 15 meter. And we were talking in that discussion, he was saying that they have to do a lot of hiking, they have to do a lot of biking. They do a lot of cross training that way. Thank you for answering my questions. Yvette. I'll throw it back to you. I know I swooped in real there real quick.
[00:07:43] Speaker B: No, you did. But it goes along the line of what I want to ask the doctor, because when a skater injures themselves and how do you react? How do you make a decision to let them continue with their practice or skating without deciding and calling them off the ice?
[00:08:00] Speaker C: So this is a tricky question, because if you look at Lindsey Vaughan, right, she tore her ACL prior to.
I think she tore acl, what, last week? Just a few days ago? Yeah.
[00:08:11] Speaker A: No, it was. It was just recently.
[00:08:14] Speaker C: And then she came down the mountain, injured herself in a different way. If I'm hearing correctly, it sounds like her team physicians had actually warned her that if she were to ski and compete, there's a high likelihood that she would injure herself. But we can make the recommendations to our athletes on what we think is appropriate and when we think they're putting themselves at risk. But they make the decisions for themselves, right? This is something that they have dreamed of their entire lives. This is what they work up towards.
It's really up to them. If they feel like they're up for it and they're ready to deal with the consequences of their decisions, we will support them in the best way that we can. But we offer our medical advice, and we tell them what we think the risks are. If I feel like my athlete or my performer is going to truly injure themselves, I will tell them.
But I don't think it's my place to explicitly hold them from anything unless it's gonna. Unless I think it's gonna risk their life, you know? But very rarely do we get into, thankfully, positions like that or situations rather like that.
[00:09:21] Speaker B: So I know every injury is different, but based on the injury, how do you follow up with an athlete when they fall or collide into somebody else? What kind of treatment plans do you suggest? And I know every patient is different. I'm just curious as to what approach you use.
[00:09:39] Speaker C: So I guess with the example of them colliding on ice, when we are ringside and we're observing all this, if we see skaters coming near each other, somebody will often scream. It doesn't matter what we scream. Somebody will make a noise. And the skaters are pretty much really aware of their surroundings. They'll stop doing whatever they're doing and they'll look around to see where the issue is.
That doesn't always work. Sometimes skaters hit each other.
Usually we kind of look at them, we look at the coaches and we give a thumbs up. We ask what they think is happening, and if they give us a thumb, we just let it be.
If they're not able to give us a sign or anything, or we notice the skater is coming toward us, we'll evaluate and see what's happening. We'll triage in the moment.
If a blade has cut into a fellow skater's limb, an arm, a leg, a scalp, which has happened, we are often equipped with suturing material on the sidelines to suture these skaters up, because often they don't want to go to the er. They want to get back on the ice. But, I mean, these things happen. It's, it's, it's a normal occurrence on the ice.
[00:10:47] Speaker A: It's one of those things where you realize it's like this is a whole mind, body, soul full on 100%, 110% commitment. So with that, with the injuries that you see, what do you feel like they're, what do you think are some misconceptions you want to dispel? When it comes to Olympic athletes and.
[00:11:01] Speaker C: Their training, they are just like you and me.
They are working nine to five jobs. Oftentimes they have families and the life isn't as glamorous as we would expect it to be. I mean, they are, they are not necessarily always born with this natural gift to do whatever sport they're doing. They have to work hard at it.
You know, some of these people who are working 9 to 5, when they get home, they spend the rest of the hours at the rink training or cross training, doing whatever they need to do.
Some of the younger skaters, they actually are homeschooled.
So they are making the sacrifices they need to, to pursue this dream and to pursue this passion in the skating world. It is expensive. The vast majority of these skaters do not come from wealth.
They're not getting money from the US Government. They're not getting money from their parents. I mean, a lot of these people, their parents are out second, third mortgages to kind of COVID their, their fees.
There are actually a lot of donors who donate to support our skaters. They house them. They, they, they have no affiliation with these people, but they understand how important it is. And they provide housing and food and all of this wonderful stuff.
And they are under the same amount of stress that you and I would be under, except at a far greater level, considering that they're on the biggest world stage at the Olympics right now. So mental health is definitely an issue.
[00:12:33] Speaker B: Yes. Well, I was going to ask with that mental burnout and also physical burnout, as a doctor, how do you help an athlete prevent from putting so much pressure on themselves and causing that emotional burnout?
[00:12:47] Speaker C: Yeah, well, you know, as a PM&R doctor, we work really well in teams. And thankfully we work with not only our physical therapists and occupational therapists and speech therapists, but we also work with psychologists. They are part of our team in caring for our patients and you know, just kind of bringing it back to you.
We actually do have a team physician that works with us. So if we feel as physicians that something and they could benefit from say, cognitive behavioral therapy. Right. We will recommend that they meet with our psychologist.
As you know, psychologists in sports are very far and few. It's difficult to find them.
So sometimes it can be really challenging. But if you make connections and you really network with the people around you who work with this population day in and day out, you could find your people.
We understand that psychological stressors can also affect how we perform physically and how we perform our day to day responsibilities as normal people. I can't even imagine what that would be when you're trying to compete on a world stage like the Olympics.
So to answer your question about how we care for them, we understand the importance of psychologists, them being on our team and making sure that they are fully acknowledged in every facet of their life.
[00:14:08] Speaker B: Thank you. With that being said, for female skaters and regarding their bone health and joint longevity as they age, because I'm a woman of midlife and I'm also a menopause coach and I know certain women go through challenges as we age. So what do you do to help them prevent those injuries, to cause them more damage as their body continues to age?
[00:14:32] Speaker C: Tough balance. Right. Because a lot of the women who typically get diagnosed with things like osteoporosis and bone weakening are often biologically. I mean, they tend to be more petite, but they're very slender.
They're automatically at risk. They're more prone to developing osteoporosis. Changes in hormonal patterns will make women prone to weaker bones.
What we usually recommend is adding some resistance training and weight training, preferably earlier on.
I mean, if you're 50 and you're just starting to exercise, add the weight training, add resistance training. Thankfully for our skaters, they tend to be more slender and more petite. However, think about all of the pressure that they've been putting on their bones, landing from jumps and pushing and skating. So that actually tends to be more protective for them.
So thankfully, as far as I know, I haven't really seen any studies that say that they're at risk for osteoporosis. I actually see that risk higher in my dancer population, especially my ballerinas and my ballet dancers. But, yeah, not so much with the skaters, thankfully.
[00:15:38] Speaker B: How do you treat patients differently than, say, a sports surgeon?
Long term.
[00:15:46] Speaker C: Long term. As a PM and R doctor, we try to encourage use of all the conservative treatments. First, we like our surgeon colleagues and we utilize them, but we usually send our patients to them after we've gone through all the other conservative things like therapy, possible injections, possible acupuncture, possible massage, if we think that appropriate. Right.
There are so many other treatments out there, and we would prefer for all of our patients, whether athletes or not, to see us prior to seeing a surgeon, because you might not really need surgery. You could probably get by doing some other stuff.
[00:16:26] Speaker B: First that question, because about two months ago, I was involved in a car accident and I suffered an injury my upper shoulder. And my physician spoke to me about injections to relax the muscle and to remove the pain. And I was cautious and I said, let me think about that. So can you tell us, for example, when a patient uses injection, what is the cause of treatment to help that injury that you have acquired?
[00:16:50] Speaker C: Like, how does it help the injury?
[00:16:51] Speaker B: How does it help the injury? Yes. Thank you.
[00:16:53] Speaker C: You know, there are lots of different injections out there. The most common that people use are steroid injections or cortisone injections.
I like to tell my patients that steroid injections will not heal anything. The idea is that it will just calm the inflammation down.
There are multiple studies out there for things like prp, which is an orthobiologic injection. And that's kind of. You take your own blood out of your arm, it gets spun in a centrifuge, and then we re inject your own healing growth factors back into your shoulder. And it's not viable in all parts of the body, but for the shoulder, it. It's great.
So there's steroids, there's prp, there are hyaluronic acid or gel injections, and that works to add some cushioning to decrease pain.
That is not for every condition in the shoulder. Usually that's sometimes used for, like, arthritis of the actual shoulder point, which we call the glenohumeral joint. So it really Varies kind of based on where your injury is, but oftentimes steroid injections, which is kind of the first line go to for pain relief, is strictly just for pain.
[00:17:57] Speaker B: So on that note, I want to ask you, doctor, so what is one Olympic level recovery habit? Every day the active woman should adopt to protect her body as she ages. What should they bring into their habits as they recuperate, as they go through certain injuries? Because sometimes people are working out on a daily basis, but they don't give enough time, like you mentioned, for their body to recuperate.
[00:18:20] Speaker C: You know, as a mom of an 8 year old and a 3 year old, I have to tell you, I do not exercise every day, although I would love to.
But you know, if I were speaking to someone like myself, right, what would I tell somebody? I would say, eat a really good balanced diet because if that's what's going to nurture you and hold you over day to day, do that. I could tell you, oh sure, get a really good night's sleep.
[00:18:44] Speaker B: But.
[00:18:45] Speaker C: But I don't even get a good night's sleep right, so why am I going to tell somebody that? So, advice I would give to others, that I would give to myself, regardless of age, regardless of physical activity, regardless of athletics or not, eat a really well balanced diet and stop smoking.
[00:19:02] Speaker B: Thank you. Thank you for that.
[00:19:04] Speaker C: Of course.
[00:19:05] Speaker B: Soon we're going to come to the end of our interview. Connor, do you have something that you would like to share with the doctor?
[00:19:11] Speaker A: Sure. I guess the next thing that I would possibly think of would have been some really incredible moments that have really stuck with you that you like to share. Any moment that like really stands out is like, wow, I'm doing something really cool here.
[00:19:23] Speaker C: You know, I have to admit there was a moment when I was in the Netherlands last month and I just stood on the side of the rink and I actually started tearing up, I think. So I grew up figure skating. I was not as good as these skaters by any means. I was actually pretty bad. But I skated, I have experience, I know what they're doing.
It's really incredible to see things on television and be amazed at what they do. But then to see it up front, like in person and seeing how fast they're going and really how incredible these athletes are.
It was moving for me to think of honestly how far I've come right from like this little girl at the rink to suddenly being somebody taking care of these athletes, doing something so beautiful, so incredible.
I mean, it wasn't some big story, but I Think for me personally, it was really quite.
[00:20:20] Speaker B: Well, can you share with our viewers at home what does it take or the grit that it took to get you to get in as a doctor and for you to travel with the Olympic team?
[00:20:32] Speaker C: I think do what you love.
You know, like, they always have that. That phrase, what is it? If you love what you do, do what you love. And I admit I have some tough days in the office, but I found my niche. You know, I really love taking care of patients and getting them back to doing what they love. But in addition to that, I've also found a way to incorporate my love for the arts into what I do every day. I found a way to maintain the arts and keep these athletes and artists doing what they do every day. And I'm a part of that. It's really cool. So find something you're passionate about in whatever way you can and involved.
[00:21:09] Speaker B: And that's the key. Find the passion, you know, carry through for you to be successful, whatever you want to do in life.
[00:21:17] Speaker C: Yeah, absolutely.
[00:21:18] Speaker B: And we see that with our athletes. So, Dr. McKay, thank you so much for giving us a glimpse into the medical heart of the US Team and for our listeners to learn more about the physical medicine and rehabilitation you do.
And I want to say for our listeners to stay vital, stay strong, and we'll see you next time on the Vital Women. Thank you so much for your time.
[00:21:39] Speaker C: Thank you for having me.
[00:21:41] Speaker A: Go, Team usa. This podcast is brought to you by MHA of Dutchess county and produced by CMJW Entertainment. This episode of the Vital Women podcast is proudly sponsored by by Salt Boutique Labs.
