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Russ Toronto — Utah's sports medicine doctor before it was cool

COTTONWOOD HEIGHTS — If you run, dance, golf, climb, cycle, throw or even know someone who does, then you probably already have heard of Dr. Russ Toronto, the sports medicine doctor who has been a fixture in the state’s athletics scene for 35 years.

He was a sports medicine doctor before it was cool, before there even was such a thing. He helped pioneer the specialty of treating injured athletes, in his free time early in his career while working as an ER doctor.

He’s treated athletes through every fitness fad that’s come along since America got off the couch about 40 years ago. He’s kept them going through the running boom, aerobics, Tabata, waffle shoes, triathlons, ultramarathons, club soccer, private coaching, Richard Simmons, Jane Fonda, Pilates, snowboarding, wakeboarding, spinning classes, the X Games, rollerblading, Fit Bit, the concussion era, the specialization era.... He came along just as the culture transition from golfing — with a cart — as the most strenuous form of exercise to interval training. He’s been treating exercisers' shin splints, plantar fasciitis and sore knees and getting them back on the field ever since then.

Dr. Lonnie Paulos, an orthopedic surgeon who knew of Toronto before becoming his partner a few years ago, calls him “one of the most trusted and knowledgeable sports physicians in the Intermountain West.”

And one of the busiest. He’s seen about 5,000 athletes per year for 35 years – which adds up to roughly 175,000 patients, enough to fill Rice-Eccles Stadium nearly four times. He’s treated bronc riders, ice climbers, ballet dancers, gymnasts, marathoners, ultramarathoners, hurdlers, pitchers, triathletes, hurdlers, sprinters and every other athlete -- little league, high school, college and pro.

He can’t go to the mall or a restaurant without being approached by grateful former patients: You don’t remember me, but … He was been approached by middle-age men who thanked him for injuries he treated successfully when they were in high school.

It always helped that Toronto was exercising as intensely as his patients and that he was a college athlete, which helped him understand athletes, biomechanics, injury and the need to return to the field after injuries or setbacks. After all, we’re talking about a man who resumed his favorite sports even after they gave him four heart attacks.

Toronto attended the University of Utah on a baseball scholarship after graduating from Highland High School. He was a left-handed pitcher for the Utes from 1970 to 1974. He didn’t consider a career in medicine initially, even though his father, Alan, was a doctor and a medical pioneer himself, a cardiologist who advanced the use of computers to monitor blood pressure. In those days the top college players were invited to play semipro baseball in the summer, and Toronto landed with a team in Farmington, New Mexico. The team found him a job in a machine shop, but Toronto decided that wasn’t for him. He applied for work at a local hospital and was hired to take care of elderly patients as a nurse’s aid.

“I drove to work one day thinking, 'This is the first job I’ve enjoyed,'” he recalls. “This is something I can do, if I can do the lowest job and enjoy it. I loved taking care of people and making them feel cared for.”

He graduated from the University of Utah medical school in 1979 and served an internship in family medicine before moving into emergency room medicine. For the next 12 years he worked in the ER at Cottonwood and Alta View hospitals. “Sports medicine was not a recognized specialty,” he says.

He made it his own specialty. In his free time he worked with Doug Toole, an NFL referee and physical therapist, treating injured athletes. On weekends he provided free sideline medical care for various teams to learn his craft and gain experience in sports medicine, helping athletes at Jordan, Alta, Cottonwood, East and Highland high schools, as well as the Salt Lake Gulls Triple-A baseball team and the University of Utah.

“No one was doing sports medicine in the ‘70s,” he says. “Then it took off in the '80s. People realized there were nonsurgical ways to take care of a lot of sores, aches and pains.”

In that earlier era, athletes saw their family doctors for athletic injuries, and their treatment usually came by way of advice: Stop playing your sport for a while. “There was never a plan for how to get you better and how to keep you going so when the injury was better you were ready to go,” says Toronto.

The first training programs for sports medicine would come along in the '90s, but by then Toronto had already forged ahead. He opened the first local sports medicine clinic in 1981, first at Snowbird and then moving it to Alta View. For more than a decade he worked 60-80 hours a week, including his fulltime ER job and the sports medicine work on the side. He’d work a midnight shift in the ER, sleep a couple of hours and then report to the sports medicine clinic while his wife, Paula, stayed home with their five kids.

“After 37 years of marriage I’ve gained a little better perspective on how important her contribution was in allowing me to do what was necessary to act on that passion I have to help others get where they want to be,” he says.

Toronto was eventually invited by Toole and two orthopedic surgeons — Tom Rosenberg and Paulos — to open a sports medicine clinic in Salt Lake City, and in 1991 he teamed with surgeons Charles Beck, Rosenberg and Paulos to open The Orthopedic Specialty Hospital. Since then Toronto has worked for several clinics and in private practice and concluded he was much more comfortable in the latter.

He bridled at being under the thumb of corporate-owned clinics where he says there was pressure to move as many patients through his office as possible and recommend unnecessary tests and referrals to specialists. That wasn’t the way he worked. Says Paulos, “I was astounded at the time he gave each patient and the thorough evaluation and diagnosis of the most difficult conditions.”

Toronto spends a lot of time with patients because he asks a lot of questions and discusses the mechanics of what they do — if it’s a sore-arm pitcher or quarterback, it might be about his throwing motion. He will even take time to watch them throw or run to determine the source of the problem, which is why he believes an understanding of sports and biomechanics is necessary.

“The most disappointing thing in the way medicine is going is that doctors don’t want to spend time asking the questions to get a problem solved,” he says. “It’s just sore, and the doctors just tell them to rest it and take anti-inflammatories. But if you don’t find out the why, it’ll come back. It could be poor mechanics. It could be a weakness. It drives me nuts when a doctor tells someone he has ‘runner’s knee.’ That’s like saying you have a headache. You should be able to pin down a reason. The new wave of sports physicians coming out doesn’t have the passion for understanding the sport or the activity.”

Toronto’s style did not sit well with corporate bosses, and it does have its drawbacks. “It can be difficult to get in to see him because of the amount of time he spends with his patients,” says Donna Staples, who coordinates the office appointments. “Sometimes you have to wait a long time. All I can say is that it’s worth the wait.”

Toronto shares the same passion for sports and outdoor activities as his patients. He continued to play baseball during the early years of his medical career in “an old-guy’s league,” and he played for Larry H. Miller’s Toyota national-class fast-pitch softball teams. At 63, he’s had four heart attacks — bad genetics, he says — two of them playing his regular games of pickup basketball and two of them while cross-country skiing in the back country. He resumed both activities as soon as he recovered.

“My motto is hit the grave well-used,” he says. “I’m doing that.”

He was alone on cross-country skis in a snowstorm at the top of Snowbird when he was hit by a heart attack in January 2010. Realizing a helicopter couldn’t reach him in the storm and that he had a two-hour window to get treatment if he wanted to minimize damage to his heart, Toronto skied down the mountain, stopping twice when the chest pains returned. During the stops, he used his cell phone to make a video selfie for his family, telling them: “This might be my last words. I love you.” He made it down to his car and drove himself to a hospital, where a cardiologist removed a clot and inserted a stint. Six months later he was skiing again in the back country of Little Cottonwood when it happened again — a clot in the same spot.

It’s been two years since his last heart attack, but Toronto was sidelined again last winter by another health issue and is still trying to recover. In January, he had a bout with flu that left him so weak that he fell and broke his ribs, which led to pneumonia and diminished heart function. Doctors discovered that his heart was pumping only 15 percent of its normal volume; it has improved to 25 percent since then. At one point his cardiologist told him he had one to two years to live, but that prognosis has improved weekly with treatment. He needs a new heart, but he calls himself a “crappy” candidate for a transplant because of his age, level of function and family genetics

Toronto has cut back his workload while he recovers, but he still can’t stay away from seeing some patients during the week.

“My greatest joy is getting someone back out on the athletic field,” says the doctor. As he says this, he is looking at the many photos that line the hallway of his practice that show his former patients performing on the athletic field. “I like seeing these pictures of people doing what they love to do. That track meet might not seem important to others, but it’s important to them, and each missed game is a lost opportunity, a missed experience. You never know what you might have accomplished that time you missed. So you create memories for people. That’s what got me into it.”


After 35 years of treating athletes’ injuries, Dr. Russ Toronto offers some observations about the state of sports.

Running shoes: “The changes to the shoe — the elevated heel and the arch support and all the padding — took away the natural movement of the foot. That’s a big cause for IT band and shoe issues. In the '60s and '70s the running shoe was a slab of rubber with a top on it, and there were no shin splints, IT bands and the hip and foot problems that we have now. We saw an escalation of lower-leg problems in the early '90s. It’s all a result of poor mechanics caused by the shoes. There’s been a dramatic change.”

Football concussions: “They keep talking about making bigger, better helmets. That doesn’t solve the problem. That doesn’t prevent the brain from getting bumped back and forth inside the skull. The way to come at it is through proper technique. Stop football players from hitting with the top of their heads.”

Year-round sports and the specialization era: “They are basically beating up kids with year-round sports like club soccer and private training programs. There is not adequate rest between seasons, and doing the same thing all the time is hard on the joints. We’re seeing so much specialization and private training for young kids. Kids just need to play their sport; that’s better than any workout they can do.

“Adults have screwed the whole thing up. There’s a lot of parent gratification going on, getting all these kids into training programs. There’s so much to learn from just playing that you can’t get from a training program. I see a lot of overuse injuries from doing too much of the same thing, or too much, period. Kids never used to get sore from playing. They just played for hours till they were done. That’s lost now. Where the whole thing went wrong was when they started paying coaches. Before that, dads were the coaches and they be there every day to practice. We’ve got gymnasts who have to practice four hours a day, six days a week. Coach (Greg) Marsden (former U. gymnastics coach) told me they spend the first year up there just letting the kids heal. It’s back, knee and Achilles stuff. It’s the same with club soccer — lots of knees and foot-ankle problems — from doing the same thing so much.”