Dr. Douglas Chang's lifelong interest in spinal and brain injuries has led him to care for everyone from astronauts, Oympians and NFL players to regular folks who have hurt themselves while playing sports on the weekend.
Chang, 50, a Carmel Valley resident, is a physical medicine and rehabilitation specialist with UC San Diego Health. He specializes in the non-surgical treatment of back pain, concussions and other injuries, seeing patients in the health systems' clinics while also participating in research projects and teaching medical students.
Among his research projects has been evaluating back pain suffered by NASA astronauts following six-month stints on the international space station in zero gravity. Many of the astronauts, upon returning to earth, complain of back pain and the study is intended to determine the cause of the problem and come up with exercise routines, such as yoga and stretching to alleviate their symptoms, Chang said.
Last month, Chang and his colleagues published a paper on the study's findings in the medical journal "SPINE."
Through UCSD, Chang is also a consultant to the U.S. Olympic Team, the San Diego Chargers and other professional sports organizations. He and his fellow orthopedic and family medicine specialists regularly attend sporting events such as the Rock and Roll Marathon or an upcoming crew event at Mission Bay, where they are on call in case an athlete needs medical attention.
Chang also travels the world to keep up on the latest developments in his field. In October, he attended an international conference on concussions in Berlin, Germany, where physicians, researchers and representatives of major sports organizations such as FIFA, the world soccer body, gathered.
One interesting development from the conference, Chang said, was a discussion of the use of sideline cameras to monitor athletes' health during professional sports events. Observers stationed in a booth and monitoring the video feed can often spot signs of injury such as a concussion that could be missed by coaches and fellow players during the heat of competition, he said.
Researchers also talked about reviewing film from past on-field incidents that resulted in injuries, to learn about the causes of injuries and adapt rules to protect players, Chang said. Such rule changes have already had an impact on reducing injuries in the NFL, he said.
In his daily practice, Chang works with patients of all ages and backgrounds, including youth sports players suffering from concussions and other injuries. As the father of two boys aged 10 and 6, he is cognizant of the importance of recognizing the signs of a head injury so that appropriate steps can be taken, such as treatment or rest.
If a child has been involved in an on-field incident, such as being struck in the head with an elbow or knee, or a collision with a goalpost, parents should watch for such signs as dizziness, headache, drowsiness or nausea, symptoms which can arise within hours or even a few days later. Other signs are sleep disturbance, sensitivity to light or noise and irritability.
"The number one thing is to be aware of signs and symptoms of a concussion. The biggest problem is not detecting and diagnosing it," he said.
The rule of thumb for returning to full activity after a concussion, he said, is to progressively increase the intensity level, testing to see if symptoms return. If they don't, he said, an athlete can be cleared to resume his or her normal participation.
In spite of potential risks, he said, he remains a strong supporter of youth sports.
"The benefits of exercise far outweigh the risks of injury from playing sports," said Chang. The bigger risk for children and adults, he said, is that of obesity due to lack of activity.
Chang encourages his own children - who attend Sage Canyon Elementary School - and others to play sports, with proper equipment and rules to maximize safety.
Chang himself was a rower in college and participated in track and field in high school. These days, he said, he enjoys swimming along with cardio workouts and weight training.