Jaime Salazar and Rani Khan, Sports Medicine

Women on Wheels:
Getting Roller Derby Stars Back on Skates

They have saucy, playful names like Anya Heels and X-Khan. They dress up in short skirts, loud knee socks and false eyelashes.

But don't let the kooky exterior fool you. These ladies skate fast, hit hard and mean business.

This is the rough-and-tumble world of Seattle's wildly popular Rat City Rollergirls roller derby league.

During the day, Jaime Salazar (a.k.a Anya Heels) and Rani Khan (a.k.a. X-Khan) are an event planner and a marketing strategist respectively. But outside of work, their passion is roller derby. Both are 31 years old and teammates on the Sockit Wenches, one of Rat City's four home teams. They also play on the league's All-Star team, and both are fan favorites.

"I love the opportunity to be physical and aggressive," says Khan. "I don't think women have an outlet for that in their everyday lives. Roller derby is the only place where you don't have to compromise on beauty, brains or brawn. All three are equally celebrated."

"Seeing us play, people get inspired to start something in their own lives, whether roller derby or something else," says Salazar. "It's such a great experience to hear people tell me what they've had the courage to try because they've watched us."

"Of course, hearing 7000 fans cheering when we step onto the track doesn't hurt either," she adds with a smile.

Like any full contact sport, roller derby comes with a litany of injuries, from strains and tears to fractures and concussions.

This is where Drs. Jim Hsu and Justin Rothmier come in. The two physicians from The Sports Medicine Clinic, part of Northwest Hospital, are the Rat City Rollergirls' team doctors, treating players' injuries on the track and in the clinic.

A board-certified orthopedic surgeon, Dr. Hsu focuses on injuries of the shoulder, elbow and knee, including rotator cuff repair, ligament reconstruction, collar bone fracture and "Tommy John," or elbow ligament, surgery. He was introduced to the Rat City Rollergirls through several physical therapists and decided to become involved when he learned they'd never had a team orthopedic surgeon before.

Dr. Rothmier is a board-certified family physician with additional certification in sports medicine. His special interests are in throwing and running injuries, musculoskeletal ultrasound, orthopedic-related injections, concussions and general family medicine. He became involved with the Rat City Rollergirls because Dr. Hsu thought his experience with concussions might be beneficial to the team.

Today, both doctors are at almost every bout. "We see injuries as they occur and are often the first responders," says Dr. Rothmier.

"It's a good thing we have The Sports Medicine Clinic," says Khan. "It's saved me quite a few times!"

Khan, who has been with the league for six years, first saw the doctors for a torn anterior cruciate ligament (ACL) in her knee. She had been hit by another player and her knee had twisted in just the right way to snap the ACL.

Rothmier_Justin.jpg Dr. Hsu performed the repair. "It's not so much a repair as an actual replacement," he explains. "The ACL is short and usually under high tension, so when it tears, the two ends cannot simply be rejoined. Instead, we reconstruct it using a length of tendon from elsewhere in the body."

Recovery takes from six to nine months, but Khan was determined to rejoin the team in five months so she could play in critical games that came later in the season. Although it was an aggressive timeline, Dr. Hsu developed a plan with Khan's physical therapist to meet the goal, and included exercises designed specifically for her sport. After hard work and not a little pain, Khan returned five months later and won game MVP in her very first game back.

"These are the ideal sports medicine patients," says Dr. Hsu. "They are intense and very dedicated. They really want to recover, but they want to do it the right way."

During her roller derby career, Khan has also suffered other injuries. Dr. Rothmier has treated her for concussion, bursitis and tendonitis, rotator cuff strains in her shoulders, asthma, and costochondritis, an inflammation where the ribs join the breastbone or sternum that causes chest pain.

"Everyone at The Sports Medicine Clinic knows their stuff. They're incredibly nice, but they also love sports," says Khan. "As an athlete, they know I don't need the same treatment regimen as someone who's more sedentary. They recognize that I have more endurance than someone who's not used to having pain all the time."

Salazar, who has been with the Rat City Rollergirls for four years, has gone through her share of pain and injury as well. Like Khan, she has had a torn ACL, along with a torn meniscus, from getting hit and then falling after tangling skates with another player. Dr. Rothmier evaluated the injury and referred her to Dr. Hsu for surgery. Following months of physical therapy, she returned to the team, stronger and more agile than before.

Salazar also developed exertional compartment syndrome. During intense exercise, the leg muscles swell as they demand more blood and oxygen to meet the greater exertion. Each muscle group in the legs is contained in its own "compartment" of tissue. "In some people, these compartments are too small or inflexible to accommodate the swelling of muscles during exercise," explains Dr. Rothmier. "That constricts the muscles and veins and prevents them from getting needed blood flow and oxygen." The result is intense cramps and pain.

After confirming the diagnosis by measuring the pressure in Salazar's legs, Dr. Rothmier recommended physical therapy to try to loosen the compartments. When the pain continued, Dr. Hsu performed a "release" procedure. During the procedure, a small incision is made in the sheath of tissue right underneath the skin of the leg to open the compartment further. "For most people, this provides almost immediate relief," says Dr. Hsu.

In Salazar's case, she was able to return to her sport seven weeks after surgery. "I play hard," she says, "but even with all the injuries and pain, it's still 100% worth it!"

She's also seen the doctors for rotator cuff and superior labral tears in each shoulder and a twice-torn medial collateral ligament in her knee. In addition, Dr. Rothmier helps Salazar manage her diabetes and general health.

"I love the team at The Sports Medicine Clinic," says Salazar. "The environment is warm and welcoming and I always get in-depth answers to my questions. They're open and honest about treatment options, which is so important to me as a patient and an athlete."

Both women say it's also important that they are able to get into the clinic the same day, or the day after an illness or injury. "Our team depends on us to be in the game, so we need to be able to address things right away," says Khan.

The Sports Medicine Clinic, founded in 1963, was one of the first multidisciplinary sports medicine clinics in the country. It brings together a variety of medical specialties to provide treatment for muscle and joint problems, including sports-related or workplace injuries. The team includes primary care physicians, sports medicine physicians, orthopedic and podiatric surgeons and physical therapists.

For Khan and Salazar, The Sports Medicine Clinic allows them to continue what has become a way of life tough, take-no-prisoners competition, but also sisterhood, friendship and an amazing sense of heart and family.

For more information on The Sports Medicine Clinic and its services, call the North Seattle location at (206) 368-6100, the Ballard location at (206) 782-3383, or visit www.thesportsmedicineclinic.com.

For more information on roller derby and the Rat City Rollergirls, visit www.ratcityrollergirls.com.