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When Dr. Brian Krabak says that sports are in his lifeblood, he is describing both his personal life and his medical career.

As a child, he played soccer and competed on a diving team. In medical school, he studied the musculoskeletal system and became a specialist in rehabilitation sports medicine.

He was a physician at the 2004 Summer Olympics in Athens when Michael Phelps won his first gold medal. He was also a physician at the Winter Olympics in Salt Lake City (2002) and Vancouver (2010). This past summer, he was at the World Aquatic Championships in Budapest, Hungary, as the head team physician for USA Swimming.

He has competed in more than 30 endurance events, including 24-hour and 36-hour adventure races, a 250-mile mountain bike race, and marathons and triathlons from Olympic to Ironman distances.

While he currently has less time to train as a competitor– in part to have more family time with his wife and nine-year-old twins – he continues to fulfill his “adventure, outdoor side” as the medical director for ultramarathons around the world.

During these 150-mile races, participants run a single marathon (26.2 miles) on four successive days, followed by a 50-mile race on the fifth day. Krabak says that part of the appeal of these races is that they take him to amazing places and extreme conditions, from the Sahara and Gobi deserts to Antarctica. The medical challenges include not only preventing and treating injuries with a small team of physicians and limited resources but also planning ahead for search-and-rescue missions should they be necessary.


Brian Krabak at ultra race in Sahara Desert

Today, all of these interests and experiences come together at UW Medicine. In his clinical practice at the UW Medicine Sports Center, Krabak works with both elite and recreational athletes. He also conducts research on how to prevent and treat overuse injuries, particularly as they relate to ultramarathon runners and swimmers.

During a recent conversation, he shared his thoughts on the following topics.

What is your role as a team physician for USA Swimming?

I’ve been fortunate enough over the past nine years to travel with the U.S. youth and national swim teams. My primary role is to provide care during specific events. I spend my time preparing for races by reviewing and addressing any ongoing injuries to the athlete as well as coordinating care with the local venue. During events, I am responsible for all the medical care for the entire team 24/7. This includes keeping on top of any chronic injuries while addressing any new ones so athletes can perform at their full potential.

Travel does come with some perks, as you get to visit these amazing places. Croatia was a wonderful spot for a training camp prior to the World Championships in Budapest this summer. The training pool venue was along the Dalmatian Coast. But I was also working hard despite what my family and friends might think sometimes.

I’m also on a Sports Science Committee, and we spend a lot of time thinking about strategies to help athletes prevent injuries, manage them in a more efficient way and improve performance. This is a wonderful opportunity to collaborate with other sport and science practitioners throughout the United States.

What is it like living with the athletes in the Olympic Village?

It’s a unique world. The athletes’ village is fun and intense. You are encapsulated in this world where outside activities are out of your mind. You focus on the daily task of keeping people healthy and on making sure the athletes are feeling at their best. You know that one little thing, like a cold, can make the difference between gold and silver or even not medaling for an athlete who has spent years of training to get to this moment.

You develop wonderful friendships not only with the U.S. athletes and staff, but others throughout the world. Sometimes you have an unexpected encounter, such as meeting the Jamaican bobsled team during the Salt Lake Games (look up the movie “Cool Runnings”). Despite the intensity, people appreciate the multicultural aspects and learning how people in other cultures train and have fun. The beauty is that the athletes are down-to-earth individuals. You learn about them not just as medal winners but as people, whether they are shy or goofy, and it becomes a family.

Those experiences are my best memory because isn’t life about our experiences?

How does your experience with elite athletes benefit the recreational athletes you see at UW Medicine?

Knowing how people train and compete at the highest levels and understanding their cognitive, emotional and physical issues helps me relate to the person who walks in the door with an injury as someone who has an equally important personal goal.

Brian Krabak at Husky Stadium

At the Sports Medicine clinic, we help recreational athletes train appropriately so they are capable of achieving their athletic goals. We also help them deal with life transitions. While a person’s internal athleticism and desire to compete may be consistent throughout life, there is a reality to how our bodies change over time in terms of strength, flexibility and endurance. Sometimes, the best solution is to adjust our goals so that the long-distance runner learns to reduce overuse injuries by becoming a triathlete.

What are you hoping to learn from your current research?

Currently, I have been focusing on understanding the physiology and mental aspects of ultra-endurance runners.

What makes some people get up and run 100 miles a week or decide that a 150-mile race is a good idea? What are the implications of this exercise on the body itself? How do they deal with pain? What types of injuries are most likely to occur during an ultramarathon? What types of interventions will prevent those injuries?

As we get answers to these questions, we are better prepared to provide medical care at each stage of the long-distance event.

How is sports medicine changing?

Sports medicine has changed a lot since I graduated from my fellowship. One area of interest for me relates to the greater focus on new regenerative medicine techniques, such as platelet-rich plasma and stem cell injections. It’s still in its infancy, but it’s starting to get really interesting as we explore how we can minimize risk of injury or treat overuse injuries by regenerating tissues, including cartilage and tendon.

Is this a good idea to change our bodies?

Regenerative medicine is promising, but we need good basic science and clinical research studies to determine what really works. Only then can we truly understand the impact these interventions will have on our bodies. As physicians, our role is to help people attain their goals within the limits of what they can handle physically and emotionally and without putting them at such risk that they cause permanent damage to themselves.

Will there ever be another Michael Phelps?

He is uniquely designed to swim. But other people are coming down the line. It’s the beauty of sports. People push the envelope. Just when you think something can’t be done, someone does it. So, yes, one day there will be the next GOAT (greatest of all time). As sports change and the human body evolves, someone will do something different. That’s the fun: trying to figure out what will happen next.

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