When a professional athlete tears a ligament, it’s not just a medical event, it’s a career moment. The wrong decision, repair or rehab plan can alter the trajectory of a season, a contract or a legacy.
Few surgeons operate closer to that pressure than Neal ElAttrache, MD, a leading orthopedic surgeon and sports medicine specialist who serves as chairman of the Kerlan-Jobe Orthopaedic Foundation in Los Angeles and as director of medical services and senior orthopedic surgeon for both the Los Angeles Rams and the Dodgers.
Over 35 years, Dr. ElAttrache has helped shape the modern landscape of sports medicine: highly specialized, data-driven and closely aligned with the physical and economic realities of elite competition.
His work has restored careers and influenced surgical techniques across the globe. Yet when he reflects on his career, he doesn’t begin with championships or notoriety. He begins with mentors and responsibility.
From a single fellowship, a 35-year career
Dr. ElAttrache never expected to build his life in Los Angeles.
“I came to Los Angeles to do my sports medicine fellowship right after my residency, which was at the University of Pittsburgh,” he said. “I came here to do the fellowship with Dr. Frank Jobe and the other great doctors, Dr. Robert Kerlan and the rest, at the Kerlan-Jobe Clinic in 1990.”
He planned to return to Pittsburgh, where he grew up. But as his fellowship progressed, conversations shifted and the Kerlan-Jobe team encouraged him to stay. What he thought would be a brief training stop became a 35-year career, which he now considers among the best decisions he ever made.
The reason was not geography. It was the people.
“I found very early on in my training … that the greatest thing you could do for yourself and that anybody else could do for you is to provide you with a great example, role model, mentor.”
As a fellowship director for more than 25 years, he passed on that same guidance to trainees: Choose your environment based on who will teach you and who will invest in you.
He believes the “10,000-hour rule,” a concept made famous by the writer Malcom Gladwell, applies across fields. Mastery comes from sustained focus, repetition and consistency, and from being given the space to truly own your craft.
That opportunity came early for Dr. ElAttrache. Senior surgeons trusted him with advanced responsibilities and, in his words, “put me in an environment far younger than I could have anywhere else; maybe younger than I deserved.”
His obligation in return was simple: outwork everyone and honor the privilege.
From battlefields to ballfields
Historically, many orthopedic advances emerged from military medicine and the need to repair traumatic injuries quickly. Today, Dr. ElAttrache believes the most significant innovations come from sports.
“If you look today and ask what the impetus is for the biggest advances in orthopedics, certainly it’s sports medicine: taking care of high-demand, very active, if not elite-level, athletic patients.”
Elite athletes present a fundamentally different set of demands. They must cut, pivot, and throw at extremes the general population never approaches. And they must do it on timelines shaped not by biology but by competition.
“I always tell the players: ‘Look, your knee doesn’t care when the first game is or when the regular season starts,’” he said. “It requires a certain amount of time and rehab to get ready. But the reality is that these are livelihoods in the balance.”
That pressure has pushed surgeons to refine techniques far beyond what was previously required. Nowhere is that more evident than in pitching.
In the 1970s, when former professional baseball pitcher Tommy John underwent his landmark elbow reconstruction, pitchers threw in the high 80 miles per hour. By the early 1990s, when Dr. ElAttrache learned the procedure, velocities hovered around 90 mph. Today, the league average is above 95 mph, and many pitchers routinely throw 100 mph.
“The amount of force and spin they put on the ball, and the movement they get on the ball with these circus-type pitches, puts enormous strain and stress on the shoulder and elbow,” he said. “So the techniques we previously used … aren’t good enough anymore. They don’t hold up well enough. So we’ve had to adapt.”
Designing operations around the actual demands of rehab and return-to-play has become the cornerstone of his innovation work.
Matching surgery to rehab
In August, Dr. ElAttrache was among Yahoo Sports’ “25 in 2025: Game Changers to Watch in the NFL,” citing his ability to help players “return from what would have been career-ending injuries a generation and, at times, a decade ago.”
He dismisses the notion of a “secret formula;” what he relies on is a disciplined and deliberate framework. Any surgical method he uses must do two things: restore normal or near-normal anatomy and withstand the intensity of modern rehabilitation.
“I needed whatever treatment I do — repair technique or reconstruction technique — to provide normal enough function and integrity to get these guys competing at a high level,” he said. “It has to withstand the demands of whatever physical therapy and rehab will be necessary to get them there.”
That meant starting not in the operating room, but in rehab rooms, and understanding exactly what therapists and trainers needed an athlete’s body to withstand.
“I always talk to our physical therapists and the team trainers. … Just working together with people like that, you learn so much.”
Once he understood those demands, he designed operations that could meet their needs.
“Show me what the athletes need to do, and show me what the trainers and therapists need to do to get them there, and I’ll figure out an operation that will hold up to it.”
That collaboration led him to develop load-sharing, bridging tendon repairs techniques that distribute force, protect the healing interface and allow earlier motion without compromising stability.
What began in the rotator cuff has since expanded to the Achilles, patellar and other tendons as explosive lower-extremity injuries rise across sports.
150 NFL players since 2023 and the Saturday physical therapy sessions
According to Yahoo, Dr. ElAttrache has operated on more than 150 NFL players since 2023. He doesn’t track his own numbers and was surprised by the total, but he feels the weight of every case.
“What may not be obvious is that I feel responsible for every single one of those guys, from the time that they come to see me to the time they get back on the field.”
That responsibility extends beyond surgery. He studies pain medications, follows emerging rehab techniques and often even shows up to physical therapy.
“I’ll go on Saturdays and be with the group of guys, and I learn so much about the process early on right after surgery and then the return-to-play part,” he said. “It’s been invaluable to me.”
He still approaches the field with a beginner’s mindset.
“I still feel like a sponge,” he said. “I want to learn and be knowledgeable of anything that is out there that can help me be better at helping these guys.”
The depth of the connection he feels with patients goes far beyond the playing field.
“What an enormous privilege it is to be able to interact that intimately with even one of these guys, and for them to trust me and trust the process.”
The calculus of trust
In Dr. ElAttrache’s view, trust is the defining currency in athlete care and also its most fragile. Elite athletes are exceptionally quick judges of character; they can tell almost immediately whom they trust and whom they’re uncertain about.
The first step in earning that trust is presence.
“When you walk into a room and meet someone for the first time, take your hand off the doorknob, sit down and really look at them,” he said. “They’ll tell you a lot about their emotions and what they’re going through by how they express themselves and how they look.”
But presence alone isn’t enough. Genuine care demonstrated through effort and understanding is what sustains the relationship. For him, that means learning an athlete’s position, assignment and responsibilities so he can fully grasp what their injury threatens and what their recovery requires.
“When you know that, it goes a long way to telling that player, ‘Oh, this guy is making the effort to really understand me.”
What still drives him
With decades of experience and global recognition, many surgeons might begin to scale back. Dr. ElAttrache has not. He still loves the operating room, the rhythm of rehabilitation sessions and the human connection that anchors both.
He is also candid about how tightly his identity is woven into the work.
“I don’t know if I really know who I am without doing what I do … I was nobody before I started to do what I do, and it gave me everything.“
For the next generation of orthopedic leaders, his advice is straightforward: Seek out exceptional mentors, outwork expectations, specialize deeply and let empathy shape your expertise.
Sports medicine may influence careers, contracts and championships. But for Dr. ElAttrache, the heart of the work comes down to a single measure of success.
“What I want is for them and myself to be able to look back and say I contributed to them getting back and getting the result they need.”
