Evaluating an athlete’s health before participation in sporting activities is standard practice in order to ensure their ability to endure the physical demands of a particular sport. The pre-participation physical exam, or PPE, has long been used in both professional as well as amateur athletes and is often mandated in most states. Many sports associations and leagues require a health exam and documentation from physicians and other health care providers to certify that athletes are healthy and ready for their sport of choice. This evaluation is universally required from youth hockey to the National Hockey League although this is where the similarities in healthcare end.
In this article I will discuss the level and kind of care that is available to a professional athlete vs. the amateur athlete. New technology gives youth and recreational players pro level care at amateur prices, making their safe and timely return to action more attainable.
Like anything else, sport and athletes have evolved. When I began working in the NHL, in 1996, I was a one-man show without the aid of an assistant athletic trainer. I did have the benefit of a massage therapist and a dedicated group of team physicians who were all an integral part of our success.
Today’s NHL is vastly different. No club is permitted, by league mandate, to have a staff of less than two athletic trainers with many teams employing three or more. Most teams continue to employ the services of a qualified massage therapist but have also added full-time physical therapists, sports performance coordinators, sports physiologists, dietitians and nutritionists. The demands of the sport, the number of games played, roster size, and travel haven’t really changed but hockey’s trend toward embracing science as an essential for success certainly has.
Fans and spectators will watch NHL games and oftentimes see an injured player leave the ice with what looks like a serious injury. This may be confirmed by the media reporting the player’s addition to the team’s injured list. But later, in what seems like an inconsequential amount of time, they see this same player returning to the lineup while appearing completely unaffected by any ill effects of his previous injury. How can this be possible? Are the bones of a professional player different from mine? Why did my high school player take twice as long to return or why can’t I return from the same injury?
These are the questions I have often been asked throughout my career. The answers are in the previous paragraph. The benefits of a full-time staff of medical professionals who are all dedicated to ensuring that player’s return begin the very moment he is injured. His physical body is cared for as well as his mental well-being. The stresses of dealing with any injury, especially a long-term injury, for an athlete who is used to being active and in control cannot be underestimated. This is where the team psychologist comes in. The player’s daily caloric intake will change and this is where the nutritionist has a role. Player performance tests ensure muscle strength is properly maintained. Every aspect is evaluated daily until that player successfully returns to the lineup.
I had a player in New Jersey who fractured his ankle in our final regular-season game in Philadelphia. The medical textbooks say this injury should take a minimum of 6 weeks to heal and an additional 1-2 weeks to return to normal activity, let alone playing without restrictions in an NHL playoff game; yet this player was able to compete in three periods of hockey only 28 days later. How is this possible? Was the team completely honest about the nature of his injury to begin with?
These are the typical questions I am asked regarding professional players when they are injured and return to action in what appears not to be humanly possible for the average person. Again, what the casual observer is not aware of is that dedicated team of medical professionals that swing into action immediately. The typical emergency room visit is not necessary because the X-Ray machine is available in the arena. The usual family physician appointment, only to be referred to an orthopedic doctor, is avoided because he is also already in-site. The decision was made to internally fix the fracture using a titanium plate and screws therefore cutting down the natural healing process. In addition, this procedure was performed at 2am immediately upon the team’s return from Philadelphia. The hospital operating room was opened at that unusual hour and completed by the team orthopedists. Intense physical rehabilitation coupled with the daily use of an external ultrasonic bone stimulator all contributed to this player’s untimely, yet successful, return.
What resources do youth, high school, and recreational athletes have to achieve timely and cost effective returns to their game after sustaining an injury? While a professional player has a full 82 games and 7 months to return from his injury they do not; even a moderate injury can cause them to lose their entire season.
Which injury simply requires rest and which requires a follow up with a medical professional? When should I avoid the waste of time and expense of an emergency room visit or an appointment with my family physician only then to be referred to an orthopedic doctor? Which allied healthcare professional is required for your specific problem? For example, do I need to see a physical therapist or chiropractor? Who can I cut out in my quest for answers and who’s the best source for the right answers? These are all fair questions to ask.
The answers lie in Telehealth for sports medicine. I’ve seen many people waste vast amounts of time and money as they attempt to navigate all the allied healthcare professionals available to them. Telehealth provides a new way to provide athletes of all levels with personalized quality care by the right medical professional from and to anywhere in the world. From training support before games to immediate evaluation during, the field of Telehealth has no boundaries. Injury evaluation, therapy and rehabilitation direction, and medical referrals can reduce unnecessary ER visits saving time and expense. Telehealth technology can travel wherever the athlete does allowing professional evaluation even during road games. This advance in the field of sports medicine now allows anyone to have access to expert advice and opinions like elite players at the highest levels.
From the NHL to the KHL to the NFL and now in Asia I have observed the evolution of sports medicine to include services to amateur athletes that were once only available to professional players. These services are more precise and specific to an individual’s actual needs. Selecting which area of care is best can still be a challenge. Medical care as well as player assessment and evaluation have evolved to telemedicine and telehealth thanks to modern technology.
Much of my work over the last ten years includes consulting for teams in various professional leagues, not only hockey, no matter their location in the world. The ability to consult and advise directly with a player in Moscow while I am in Chicago or instruct a player’s on-ice rehabilitation protocol in real time from Seoul to Sherbrooke has certainly been a sign of sports taking advantage of technology. Evaluating a situation on paper, while utilizing video is the new normal.
Telehealth care for sports is an efficient and modern way to access the benefits of having access to qualified and experienced professionals who can help by reducing the time, expense, and frustration associated with inevitable sports injuries. It’s a great way for all athletes, no matter their level of play, to have dedicated staff just like the pros.