Players as patients — How to get elite athletes back on the ice

Orthopedic Sports Medicine

Keeping athletes healthy poses a unique set of challenges for medical providers, especially at the professional level. Tasked with getting the players back in the game, providers must also ensure players' safety takes priority.

Midwest Orthopaedics at Rush hosted the inaugural Chicago Sports Summit on Oct. 5. Athletico was the title sponsor for the summit. During a panel titled, "Keeping Our Athletes Healthy: The Risks, Liabilities and Economics," sports medicine experts and Blackhawks' Coach Joel Quenneville described their experiences caring for injured athletes.


The panelists included:


•    Mark Bartelstein, founder and CEO, Priority Sports & Entertainment
•    Mark Kaufman, president, Athletico Physical Therapy
•    Gordon Nuber, MD, Northshore Orthopaedic Institute; Chicago Bears team physician
•    Joel Quenneville, head coach, Chicago Blackhawks


"When an athlete chooses you to represent them, they are literally putting their future in your hands," said Mr. Bartelstein.


Balancing athletes' expectations with safely returning them to play
Athletes have an important role to fulfill, as millions of sports fans from around the nation fill stadiums to watch their favorite sports team hopefully prevail over their contenders. Well-known for their ability to play through the pain, hockey players, especially a Chicago Blackhawk, have big skates to fill and Mr. Quenneville said maintaining their health and ability to play comes down to team leadership.


"Everyone has some type of issue. They find themselves a way to get healthy enough to get back out there," Mr. Quenneville said. "Our core guys find a way to put the time in, play with the pain and send a message to the team. Many will do anything to play during the playoffs."


When players do suffer injuries, the team is equipped with a medical team working directly with the players to get them back on the ice. As the coach, Mr. Quenneville notes he is "basically at the end of the decision making process," after the medical team determines the player is ready for action.


Athletes often don't let pain take them off the field, and may cut an appropriate recovery time short. Mr. Bartelstein manages this dynamic everyday, considering when and whether an athlete should return to play.


"In the NFL, the players to some degree, can be replaceable, so there's an enormous pressure on NFL players to get on the field, because once someone takes their spot, they may not get it back," he said.


Mr. Bartelstein's job involves trying to keep these athletes in top health so they can perform and fill expectations. His team collaborates with a group of physicians from each specific medical field as well as with all team physicians.  


"What we try to do is bring together a consortium, of the trainer, the team doctor and the outside consultant, and we'll get together and then remove all the other noise," said Mr. Bartelstein. "And then come to a decision, and it's not a science, it's an art."


The role of a team physician
Confusion often resonates among players, as they don't know if team physicians are loyal to them or loyal to the team.

Dr. Nuber has served in various practice settings over the course of 25 years, from universities to hospitals to private practice.


"Liability is pretty significant," said Dr. Nuber. "At the end of the day, yes we are employees of the team, but you have to be the player and patient advocate...Your allegiance has to lie with the player."


Although team physicians deserve fair compensation from the team for their significant amount of work and time, Dr. Nuber stresses the ultimate role of a team physician is to serve the patient.


A vital aspect of patient responsibility is keeping that information confidential. When an athlete sustains an injury, especially if that athlete is among the team's star players, many sports fans will troll the internet seeking any information as to when they can expect that player back in action. However, information is often limited, with hockey being among the sports that discloses very little information about the player's injury and projected recovery time.


"Our sport is very competitive and tight,” Mr. Quenneville said. "Teams don't disclose their exact injuries because we know it is targeted [by the media]. Players are told not to disclose anything and get the proper care so they can get back to the game."


The evolution of injury management
Having a trainer on-site is of increasing importance, as sports are evolving, and many times, these changes can pose more risks to athletes.


"Our sport has never been faster and the exposure to injuries is real," Mr. Quenneville said. "People want to see it. Hitting is still a key part of our game."


With bigger and faster players, professional sport leagues may consider changing the rules for safety purposes.


"Physics dictates that they are going to be injured when they run into each other, this is like the equivalent of a car crash," said Dr. Nuber.


Injury management is changing, and the healthcare industry is placing a higher emphasis on injury prevention especially as concussion awareness and the possible side effects gain traction in the media.


When he was a player, Mr. Quenneville noted a sport team's staff featured a coach, assistant coach, trainer and a team physician. Today, the staff is much more diverse, with players often having access to nutritionists, strength coaches as well as teams of physicians and trainers. Having trainers available to diagnose concussions almost immediately after they occur is integral in managing a player's injury.


"When you get patients in the hands of a physical trainer or athletic trainer early on in the spectrum of care, you will go a long way in getting that patient back on the field and back to daily living," Mr. Kaufmann says.


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