This commitment is what led Dr. Mathien, a senior orthopedic surgeon at Knoxville-based Tennessee Athletics, to be named the 2025 Southeastern Conference Team Physician of the Year for Orthopedics.
“I have had 33 years and 34 seasons of opportunity to care for [University of Tennessee]athletes. I think that’s probably what provided me the opportunity to receive this award: The longevity that I’ve had, and the involvement of the care of student athletes at UT. We do this as a team. Although this is an individual reward for me, it speaks to the longstanding history of the clinic’s relationship, the standard of care that has been established and has been maintained throughout the history of that relationship, and all of the team members who participate in that care,” Dr. Mathien told Becker’s. “We participate in the care of the athlete in a team approach. My role has evolved over the course of time, but even with the evolution of healthcare, we have maintained the level of excellence we think is so necessary to provide athletes care they need. I think that has a lot to do with why I received this award.”
Dr. Mathien has spent 34 seasons providing care for all University of Tennessee athletics, from men’s to women’s sports. He has seen several changes in the industry, from new rules and protocols for college sports, to new, more severe injuries among patients.
“Athletes have, over the course of time, become bigger, stronger, faster. The magnitude of injuries has increased, along with the severity and frequency. The competitiveness has evolved and the pressures of the care of the athlete have evolved with that. The athletes of today are uniquely different from the athletes of 30 years ago,” Dr. Mathien said.
“That has a lot to do with the evolution of youth sport and we see a tremendous increase in the number of injuries in youths. In the ’60s and ’70s when kids were young, they played in the backyard and did multiple sports. As time has evolved, we see a higher incidence of injury in young athletes because they become single-sport athletes in competitive environments. Adult-style injuries are seen much more frequently in younger athletes and there are long-term consequences to that. Youth sports have evolved in a negative way relative to frequency and severity of injury that has long-term impact.”
While injuries have evolved, so has the technology making treatment easier and more effective.
“The level of sophistication for arthroscopic surgery has evolved over the course of time. That has been an advantage to the care of the athletes. Imaging technology has improved over time, so has the ability to detect, and the awareness of medical staff, trainees, physicians. There’s a heightened awareness. When you couple improved diagnostic tech with improved surgical tech, the hope is that it leads to more positive outcomes,” Dr. Mathien told Becker’s.
“In 1991, there were no electronic medical records, MRI scans weren’t used as liberally as they are now and there were no cellphones. It was old paper sheets and beepers and a total different way of caring for athletes than now with the evolution of technology. Having said that, the goal is still to provide ultimate care to the athletes.”
On top of spending the last 34 seasons improving his orthopedic practice skills, Dr. Mathien has also worked to prioritize his relationships with patients and their families.
“I try and create a relationship with each patient — athlete or not. A good physician treats the disease, a great physician treats the patient with the disease. For a lot of these athletes, this may be their first injury. Their sense of invincibility is destroyed,” Dr Mathien said. “There’s a larger emotional component that frequently goes along with these injuries for athletes, parents, families. That is where the calm comes in, because there is a fair amount of angst in that process. You can still provide compassion, but the calm in that process, and the relationship you have housefully established over time, makes that process more manageable.”
Unfortunately, maintaining that colm is becoming more difficult for many physicians, as the world of college — and professional athletics — remains increasingly competitive and serious.
“The thing that has changed a lot over the last few years, and I think it’s debatable how this will continue to evolve, but with the advent of the name, image and likeness, and the professionalization of collegiate sports, it makes care much more challenging. Thirty years ago, an athlete came in as a freshman and spent four or five years at the institution to get a degree because the phrase we used then was ‘student athlete,'” Dr. Mathein said.
“As we have evolved with the transfer portal and NIL, those student athletes are much more mobile for various reasons, so you don’t have the opportunity to create relationships with those athletes that are so critical to make you confident in case. When you don’t know the athletes because they have not been here as long, as they go from place to place in their opportunities, it makes it much more challenging to create those relationships that are crucial for optimal care. Unfortunately, that’s been a real challenge.”
Another challenge that Dr. Mathien deals with on a daily basis is helping athletes and families stay calm in moments of crisis. With the increased seriousness of collegiate sports, people can treat major injuries like they are world-ending.
Dr. Mathien focuses on helping athletes and their families maintain positivity by setting an example through his own actions.
“When I talk to young sports medicine physicians, the one thing that has been a continuing goal of mine is a quote from a Navy SEAL. ”Calm is contagious.’ As sports medicine physicians, we are in a leadership role. People look to us, and we are the leader of that team and that decision-making. When you, as that leader, are calm, it makes for a much more successful and efficient care for that injured athlete. If we get caught up in the excitement of the moment, that creates challenges in the dissemination of care,” Dr. Mathien said.
“For me, personally, I have always tried to maintain a calm demeanor in that environment to set an example for the entire team to try and optimize and make the most successful and efficient care. Things get exciting in the athletic realm and you need to be able to maintain perspective and not get caught up in the excitement of the moment. You need to remain calm to allow for clarity in the care of the athletes. I think most all sports medicine physicians would tell you that in some way, shape or form. I think that’s a crucial element to providing that care.”
And while it may be easy for many to get caught up in energy and excitement on the sidelines, Dr. Mathien refuses to let himself get caught up in the fanfare of a game.
“As a sideline physician, you watch games differently. You are always watching for the player that doesn’t get up, is somebody not moving properly. You’re not watching a game as a fan, you’re watching the game as a physician,” he said.
“With that calm, you try not to get caught up in the emotion of the event. You can’t control what happens around you, you can only control how you respond to it. By being that rock, you can provide some strength and comfort to the families who have had their whole world fall down around them with an injury. There’s a large emotional component to this. The training staff, who know athletes intimately, help hold that athlete up as their world is crashing down.”
