Prompt care for sports injuries makes all the difference
Everyone has become familiar with doctors and training staff being on the sidelines, courtside, and in the dugout for most sporting events. Fans have come to expect immediate help for our modern-day gladiators that get injured on the field of play. With bated breath, other players and spectators alike wait to hear an update on the status of the fallen comrade while announcers replay the moment and pose educated guesses as to the type of injury and the impact it could have. It’s an important, yet often overlooked, element of sporting events. But how did all this begin?
Sports medicine as a form of practice is actually not new. Ancient Greek and Roman physicians Herodicus and Galen rendered care to some of the original Olympians. The Edwin Smith papyrus from 3000BC, which was translated in the 1920s, documents a case of shoulder dislocation as well as other trauma. Orthopaedic surgeons have been treating trauma and sports related injuries for hundreds of years; however, it wasn’t until 1954 that the American College of Sports Medicine was founded which promoted and codified research and clinical treatment of the athlete.
Tradition of Healing in TN
Knoxville and the University of Tennessee have had a long tradition of sports medicine thanks to some of the founding members of the Knoxville Orthopaedic Clinic (KOC). Bob Brashear was the first team physician for UT. He graduated from medical school in 1928 and was a UT student health physician and then completed an orthopaedic residency at the Campbell Clinic from 1938 to 1941. He then moved to Knoxville and became the team physician for UT, but like most able bodied men in that day, Bob and his partner Dr. Tommy Stevens enlisted and served our country in WWII. Bob and Tommy returned to Knoxville in 1946 and resumed their roles as team physicians and branded themselves as Knoxville Orthopaedic Clinic in 1959.
Dr. Bill Youmans joined the group in 1968 and continued the KOC tradition of caring for the UT athletes until he retired in 2006. Bill was not only the team physician, which was a novel concept at the time, but was a founding member of the American Orthopaedic Society for Sports Medicine which had its first meeting in 1972. In addition, Bill started a sports medicine fellowship here at KOC.
Fellowships are an extra year of training after ortho-paedic residency and offer heuristic education under a seasoned professional. Since Bill was a pioneer in sports medicine, Dr. Greg Mathien seized the opportunity to become one of his first fellows in 1992 and joined Bill in the sports trenches the following year. Dr. Russ Betcher subsequently completed the Youmans fellowship in 1998 and complemented Bill and Greg on the sidelines. As a UT alumnus, Dr. Matt Rappe always dreamed of being on the sidelines and running through the “T” and that dream came true in 2007 when he joined Greg and Russ as UT physicians.
Caring for Athletes
But enough about the history and lineage. What is it like to care for athletes, and how has this practice changed over time? To answer these questions I contacted my partners, not about a patient or practice management, but about stories, and more specifically their stories and thoughts, some of which, I imagine, will surprise you.
I always enjoy talking with Bill, who reminds me of Bob Newhart with his penchant for dry wit and unabashed honesty. “I did not consider myself a fan,” he told a reporter once. At first this seemed at odds with the perennial furor of the Tennessee faithful, until the follow up. “I felt that being a fan might alter my treatment deci- sions, and my primary concern was always the welfare of the athlete and person.”
A truly refreshing take on medicine. Bill’s most mem- orable moments were the joy and satisfaction of seeing athletes return to play. Back in the day, it was common to see Bill and his players in the paper, but he always stayed true to treating the person first.
Greg, Russ, and Matt continue this compassion-focused treatment of the athletes at UT. It might be surprising to some, but the familiar sideline presence is just the “tip of the iceberg,” as Greg put it. About 90% of their time is spent in the training room and on calls with trainers, players, and families. It is very much like another full- time job. Despite the time commitment, each one finds it enjoyable with indelible memories of the football win at Notre Dame, the home win over Alabama when Neyland erupted, and the recent historic National Championship run of the UT baseball team.
To the men, overwhelming gratitude was expressed for the efforts of Dr.’s Chris Klenk and Amber Luhn who serve the primary care needs of the athletes. There are many facets of the comprehensive medical program that they provide which includes nutrition, concussion management, stress mitigation, and mental wellness. “The stress level can be quite significant for the players with the advent of NIL, revenue sharing and social media,” Chris said.
They employ a multidisciplinary approach with curated experts in all domains to provide care from dietitians, nutritionists, and therapists when needed. Concussion diagnosis and management has come a long way in just the past 30 years. We used to just hold up some fingers and ask the player to count them and guess the correct year. Now, they use functional imaging and electroencephalogram data to aid in diagnosis and return to play.
Does the stress and pressure of social media and revenue sharing pour over to the medical staff and foist more responsibility on them? One can imagine a beleaguered medical staff member trying to assimilate information knowing that careers are on the line. Russ said, “It now requires input from multiple sources, but the same goal is still at the heart of the matter…the health of the patient.” However, the NIL is not all negative, as Matt has found that, “the athletes are more invested in their physical and nutritional well-being.”
Serving the Community
UT is not the only institution for whom the KOC physicians provide services. Many of us are on the sidelines at every high school football game and render orthopedic care to all the student athletes. This coverage would not be possible without the help of the high school athletic trainers who run point on all the sports in the respective schools. You will see them in the training rooms managing physical therapy and keeping us informed on the current status of the players.
Sports medicine was born from some entrepreneurial orthopedists who saw a need. It has now grown into a multi-billion-dollar business that is as convoluted as an MC Escher print. However, when distilled to its most basic component, it is the care of an athlete, who is first and foremost a person who entrusts their very welfare to us. This is one of the most sacred of relationships, which we extend to all patients, athlete or not.