Emory's Got Game

DOCS TO THE PROS

WHEN MATT RYAN, the All-Pro quarterback of the Atlanta Falcons, drops back to pass, he might look for Tevin Coleman in the flats, or Mohamed Sanu on a slant, or his favorite target, the superstar receiver Julio Jones, streaking up the sideline. 

But Ryan knows that no matter what the play-call, one thing never changes—at every game, in every city, Spero Karas, Emory associate professor of orthopaedic surgery, is on the thirty-yard line, eyes fixed on the field, ready for whatever the day may bring. 

“My mantra is stay detached, stay clinical, stay alert,” says Karas, who, as the Falcons’ head team physician, sees to it that players are, as he puts it, “wrapped in a blanket of world- class care.” 

That care extends far beyond the sidelines. It starts with preseason screenings of eye and heart health, continues with training in injury prevention, and invariably involves the surgical and medical care of injuries and illnesses—everything from torn ligaments and broken bones to dehydration, the common cold, and concussions.  

For all of it, Karas draws on the resources of Emory Healthcare—now the official team health care provider of the Atlanta Falcons with some of the finest specialists in the field.  

Among them is Brandon Mines, Falcons team physician and an assistant professor of orthopaedics with expertise in conditions of the knee, wrist, ankle, and upper extremities. 

“I enjoy helping the players stay healthy and get back to the game they love,” Mines says. “It’s great to build a rapport with them and help them stay focused when there are so many distractions around them.”

Jeffrey Webb, an assistant professor of orthopaedics and the Falcons’ concussion specialist; Kyle Hammond, an orthopaedic surgeon specializing in ligament injuries to the knee, shoulder, and elbow; and John Xerogeanes 92M, chief of the Emory Sports Medicine Center and associate professor of orthopaedic surgery. 

“I was always frustrated when I got hurt and couldn’t get back to play,” Xerogeanes, who is known to his patients as “Dr. X,” recalls of his college days as a linebacker at the University of California–Davis. “I had a great team doctor who helped me out a lot, and I knew that’s what I wanted to do.”

A former collegiate athlete himself, Karas lettered in wrestling at the University of Notre Dame and was a three-sport star in high school in Indiana. He saw his first action with the NFL while completing his sports medicine fellowship in Colorado, where he served as an assistant team doctor for the Denver Broncos. Several years later, he signed on with the Falcons, becoming the youngest head team physician in the league. 

But Karas’s work isn’t confined to the clinic. A distinguished researcher, he’s contributed to significant advances in rotator cuff repair surgery. And as director of the Emory Orthopaedic Sports Medicine Fellowship Program, he oversees the training of young surgeons just starting their careers. 

With its wealth of resources and roster of renowned specialists, Emory is a particularly attractive place to do that. Sports medicine fellows get to work closely with elite athletes—and not only the Falcons. Emory Healthcare also serves as the official team health care provider for the Atlanta Hawks, the Atlanta Braves, and the Atlanta Dream, as well as Georgia Tech and several other college and high school athletic associations.

“They travel with the teams, help out at the games, and sit in on the evaluations,” says Karas. “And that has a lot of appeal.”

Long a niche specialty within the field of orthopaedics, sports medicine has exploded during the past two decades, a product in large part of the exponential growth of organized sports. Kids are starting sports earlier and increasingly playing them year-round, while adults are more frequently engaging in vigorous exercise, with many staying active well into their eighties. 

All that exercise has been a boon to public health, but it’s also led to a sharp increase in sports-related injuries. Emory Healthcare has responded to the need, adding faculty members, forging partnerships, and building new facilities.

Emory’s Sports Medicine Center now has digs in the Sports Medicine Complex, a new, state-of-the-art facility that doubles as the official practice and training site for the Atlanta Hawks. Not surprisingly, it features a pair of full-length basketball courts and adjacent training areas, a film room, a recovery room, and a separate entrance for the big guys.

But Atlanta’s pros are hardly the only patients who receive care at the 90,000-square-foot facility.

“We take care of ordinary recreational athletes and high school kids with the same doctors and therapists, and in the same place, that we take care of Olympic athletes and professionals,” says Scott Boden, chair of orthopaedics and director of the Emory Orthopaedics and Spine Center. 

Founded in 1994 with just four physicians, the center now boasts two dozen specialists in every aspect of spine care, with a hospital and seven full-service clinics throughout metro Atlanta in addition to the Sports Medicine Complex. 

“We’re blessed to be one of the largest spine centers in academic medicine in the country,” says Boden.

The accumulation of noted expertise has made the center one of a select few to be listed as a preferred provider for retired NFL players—who come with a different set of physical challenges than current players.

“The retired players have more chronic arthritic problems and less acute injuries,” Boden says.

The sports medicine team also is vigilant about the now-well-documented effects of repeated blunt-force trauma to the head.

There was little public awareness of the link between football and degenerative brain diseases like chronic traumatic encephalopathy, or CTE, until a decade ago. That’s when sports medicine experts, including from the NFL, began to acknowledge and draw attention to the long-term effects of concussions. 

The 2015 movie Concussion and other real-life stories brought to light by players have led to greater understanding of the long-term risks of football, accompanied by increased precautions, improved prediction models, and new treatments. Still, the intense scrutiny has fueled fears of CTE among players both active and retired. 

“What we’re seeing now is a huge amount of anxiety around this condition,” says Anthony Stringer, Emory professor of rehabilitation medicine. “There’s a whole mishmash of symptoms associated with [CTE], so players are frightened that they could get it or that they have it.” 

A clinical neuropsychologist, Stringer focuses on helping people maintain their cognitive independence after an impairment—whether from brain injury, stroke, or simply aging. 

“Truthfully, sports concussion is a very small part of our patient population,” he says. “The majority of our patients are experiencing difficulties because of brain injury in a car accident or a small stroke.”

But with all the publicity surrounding CTE, he says, football players have become hyper-vigilant about any small blip in cognition. During the past decade, dozens have come to him with concerns.    

“We’ve even had Canadian Football League players come in to see if what they’re experiencing matches what we call CTE or what their risk is for developing it,” he says. “I saw a  player recently who looked good, but had some memory impairment in excess of what one should for his age, and he was worried about his children.” 

That player decided to retire, he says—but with their athletic careers at stake, “Others are willing to take the risk.” 

Stringer says his job is often just to allay players’ fears, to let them know it’s normal to forget where they left their car keys or why they walked into a room. But not always.

“There are those times,” he adds, “where we do see things that advise us to tell the athlete, well, yeah, you are showing problems and you have to think about whether or not you want to put yourself at further risk.”

With Atlanta set to host Super Bowl LIII, Emory’s sports doctors are prepared to get their heads in the game—whatever role they might be called on to play. 

“We can be a liaison for the teams’ medical staffs,” says Karas. “Whatever they need, we’re here to provide resources.”

But the players are only part of the production. Emory Healthcare is offering priority medical services to the “NFL Family,” the organization’s family members and myriad contractors—about three thousand total—through a dedicated phone line staffed by specialists during the events.

And when the big game is over, Emory’s sports medicine team keeps on practicing. You could be a WNBA Atlanta Dream player, or an Atlanta Rollergirl, or a college or high-school soccer player—and still be treated by Falcons docs like Brandon Mines.

“I chose sports medicine because it really does encompass patients who are excited about exercising and like to stay fit,” Mines says. “I like to help people get back to their sports after an injury, because it’s very important to them.”