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Injuries are an inevitable part of life in the NFL, as are other types of medical issues and emergencies, but most fans know little about how the players are protected before, during and after games—and who the team physicians are.
As the Jets and Giants get ready to kick off their seasons at MetLife Stadium—the Giants on Sunday, September 10 against the Dallas Cowboys, and the Jets, led by new quarterback Aaron Rodgers, on Monday, September 11 against the Buffalo Bills—the doctors on the sidelines need to be as prepared as the players.
“It’s a 24/7 commitment. You’re always on call, and you need to be available to the players, the coaches, the staff,” says Dr. Damion Antonio Martins, head physician for the Jets. “I warn [medical] fellows: If you are a 9-5 person, sports medicine is not for you.”
PAGING DR. NFL
Ronnie P. Barnes has seen the evolution of medical care for NFL players during his four-decade career with the New York Giants.
When Barnes joined the Giants’ medical staff in 1980 as head athletic trainer, he worked with one orthopedist, one medical doctor and one assistant trainer. Now, each team has about 30 game-day medical professionals on the sidelines, the NFL says.
“There’s no limit. The NFL talks about 30, but in some places, it’s a lot more,” says Barnes, now senior vice president of medical services and head athletic trainer for the Giants. “We’ve been increasing not only the care but the knowledge in sports medicine astronomically over the years, and we’re still growing.”
In addition to Barnes, the Giants’ medical staff includes six athletic trainers, three of whom have doctorates of physical therapy and are responsible for the rehabilitation of athletes; a primary care physician; a primary care fellow; and orthopedic surgeons. Also present on the sidelines during games are emergency room physicians, paramedics, a chiropractor and an airway management specialist.
A gastroenterologist is on the field before games–did a player vomit because of nerves or illness?—and then is on call in the stands all four quarters. An ophthalmologist is on call but not in the stadium. And the NFL requires each team to have an unaffiliated neurotrauma consultant on the sidelines to evaluate any player who may have a concussion.
Barnes says additional doctors on the medical roster can include a hand surgeon, a spine surgeon and a spine neurosurgeon.
The most dramatic addition to the Giants medical team came in 1986, after tight end Mark Bavaro broke his jaw during a game. “[After Bavaro returned to play], the dentist was there [on the sidelines] in the event that we needed to cut some of the wires, if he got sick or, you know, couldn’t breathe,” Barnes says.
A dentist stayed on the sidelines for the rest of the Super Bowl-winning year, but now sits in the stands, with tickets provided by the Giants.
NATIONAL ATTENTION
The role of NFL teams’ medical staff received national attention in January, when Buffalo Bills player Damar Hamlin suffered cardiac arrest during a game. The on-field response was broadcast live until Hamlin was carted away and the game was canceled. Hamlin is making his big return to the field when the Bills take on the Jets Monday night.
For the Jets, a hotly anticipated return this season is running back Breece Hall, whose hot rookie season was sidelined last year when he tore his ACL during a game against the Denver Broncos in October. He returned to practice at training camp just a few weeks ago.
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Like the elite athletes on the field, the medical staff works hard at training camp during the summer, handling heat illness and other issues that arise.
“I’m responsible for making sure that they’re properly hydrated all day long, not just on the field. So if you want to call us water boys, we’re water boys–water boys and girls, because we have men and women athletic trainers on the staff,” says Barnes, 71, of Cedar Grove. “Part of my job is to educate [players] about hydration, even though they’ve been playing for a long time.”
The medical teams have their own training every spring, making modifications as needed to improve the care plan for the next season.
On game days, the doctors start their day three to four hours before kickoff, checking to see if the athletic trainers need anything and evaluating any player who does not feel well. The NFL’s 60-Minute Meeting is “an essential checkpoint to ensure officials, team medical staff, and gameday medical personnel are aware of all in-game player health and safety procedures and resources,” according to the organization.
“We meet outside the officials’ locker room, and the officials, the head referee, is there. That is so important because if they recognize something, they can let us know,” Barnes says. Throughout each game, everyone is alert to a potential injury or problem with a player.
During the game, the physicians have a designated area at the two 30-yard lines and generally stay at their spot, while athletics trainers will move up and down the sidelines, following the ball, if they are not up in the booth.
After the game, the physicians typically stick around for one or two hours. “If there were any injuries or issues during the game, players are seen immediately and then evaluated,” says Dr. Dean W. Padavan, associate team internist for the Jets.
The physicians travel with the team to away games, but there is also a local doctor designated as the VTML, or visiting team medical liaison. The VTML can write prescriptions, which the traveling doctors can’t do in another state, and also escalate care to a local hospital when necessary.
Dr. Martins and Dr. Padavan work as doctors for Atlantic Health System, which has a multiyear partnership agreement with the Jets. During the season, they staff the Jets sparkling training facility in Florham Park—the setting of the recently aired season of HBO’s Hard Knocks, which was filmed during training camp—evaluating a player who may feel ill or administer testing.
Doctors working for pro teams know they have a dream gig, but the public may not realize how intensive the work is.
“It’s an amazing job. I’m not gonna lie,” says Dr. Padavan. “But there’s a lot of help and support that goes behind it. I think a lot of people who don’t do it, maybe don’t understand how much work goes into it. So you have to love it, and we do.”
BUILDING BONDS
The medical staff also strives to build trust with the players, a bond that is fostered by the doctors eating with the team and staying at the hotel for away games.
“Sports is a real community. They get to know you, and I think the most important thing is for them to know that you really care,” says Barnes, who was inducted into the Giants Ring of Honor last year.
Dr. Kameno Bell, an emergency medicine physician with the Giants, believes his playing days help him relate to the players. “They can confide in me more casually, maybe, than some others,” Dr. Bell says.
Dr. Bell was a walk-on football player at University of Illinois and then drafted by the Miami Dolphins in the 12th round in 1992, spending two years in and out of the team’s system, mostly on the practice roster. Dr. Bell says he saw a “frustrating, fledgling career, trying to get my foot on the playing field in football” and decided to go to medical school, taking the entrance exam while in training camp in Miami.
He had been pre-med at Illinois, and returned there for medical school. “Half the class knew who I was when I walked in, and they were like, ‘What are you doing here and not playing football?’” he recalls. “I would have rather remained anonymous.” In school, he switched from surgery to emergency medicine and then had an opportunity for a fellowship in sports medicine. “It was kind of like coming home, combining medicine with sports, something I had done all my life,” Dr. Bell says.
A DREAM GIG
Turnover in these NFL physician positions is rare. “It is one of those jobs where, once you are afforded the opportunity, people don’t leave. At all,” says Dr. Bell, 53, of Montclair.
When there is an opening, it is usually filled through referrals or a fellowship program at a medical school.
One of Dr. Bell’s coaches in college, Denny Marcin, became a coach for the Giants, leading Bell to connect with Barnes and eventually land a spot with Big Blue 15 years ago.
Dr. Padavan was first introduced to the Jets during a sports medicine fellowship with Atlantic Health in 2011; the team hired him in 2014.
During a fellowship in sports medicine at University of Maryland, Dr. Martins served as a fellow team physician for the Baltimore Ravens. He began consulting for the Jets in 2002 and then started a full-time role in 2009. Dr. Martins is also the director of orthopedics and sports medicine at Atlantic Health.
Barnes was referred to the Giants in 1976, helping during summer camp, while he was an athletic trainer during grad school at Michigan State University. In 1980, the New York team hired Barnes full time as head athletic trainer, then he was promoted to vice president and then senior vice president of medical services.
Many of the team doctors work at a hospital too. “It’s sometimes a little bit tricky to juggle, but we try our best so that we’re making sure that the players get the best care, as well as our patients in the clinic,” says Dr. Padavan, 43, of Morristown.
Dr. Bell works full time at Hackensack University Medical Center and says the hospital is accommodating of his work with the Giants. “I just kind of coordinate to make sure things run smoothly,” he says.
Some doctors also have roles with nonprofessional teams. “What we try to do is take [our pro experience] and try to mimic it at our college teams and high school teams. Obviously, the resources aren’t the same. The NFL and professional organizations set the standard for how to take care of an athlete,” Dr. Padavan says.
One trait that distinguishes the pro athletes is they are highly motivated to get better. “It is very rewarding to see someone who has an illness, injury or issue overcome that because they’re highly motivated to get back to participation,” says Dr. Martins, 51, of Harding.
The medical staff may have to rein in that enthusiasm, at times. “I think our biggest job is protecting athletes from themselves,” says Barnes, noting players may want to return to the game after an injury before they’re fully rehabilitated. “That’s our job to make sure that they can return safely, and that’s the job of everyone in the league.”
Enthusiasm of a different sort comes from the physicians’ families. Dr. Bell has three daughters, who are becoming more interested in football. “Up until maybe a year ago, they wouldn’t have had a clue what I did. But as they get older, in school, their friends have found out, and now all of a sudden they have questions about it,” he says. “Everybody thinks it’s cool.”
With all the travel involved, the doctors credit their spouses and children for being understanding. Dr. Padavan has two sons, ages 10 and 7, who watch every game on TV, looking for their father on the sidelines.
Sharon Waters is a writer living in Bloomfield.
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