Dr. James Andrews offers glimpse into SEC football and more

John David Mercer-USA Today

The SEC isn’t just first in football. It’s also first in sports medicine thanks to Dr. James Andrews, the world-renowned orthopedic surgeon. While he has made headlines recently because of his work with the Washington Redskins, Dr. Andrews has long made his home in the SEC. A former college track star at LSU, where he also attended medical school, Dr. Andrews served as lead physician for Kentucky’s football program before succeeding his mentor, Dr. Jack Hougston, as team doctor for Auburn in 1992. Today, Andrews also serves as team doctor for Alabama as well as the Redskins.

John David Mercer-USA Today

Dr. Andrews recently co-authored Any Given Monday with former Sports Illustrated editor Don Yaeger. While partially autobiographical, the book is primarily designed to serve as a guide for parents, coaches and athletes on how to identify and manage common sports injuries. Dr. Andrews surveys over two dozen sports, providing a broad overview of the sports medicine landscape. Unlike a lot of the recent reporting on football players and concussions, Dr. Andrews does not resort to sensationalism or scare tactics. Rather he tries to present a professional analysis based on decades of experience.

There’s nothing groundbreaking in the chapter on football. Dr. Andrews notes that it does produce the most sports-related injuries—over 920,000 at the high school level in 2007, according to one federal government report—and that concussions are the most serious and common injury. The chapter also covers Dr. Andrews’ specialty, ACL injuries requiring surgical reconstruction, and more basic issues of player exhaustion and dehydration.

Perhaps the most interesting chapter is one dealing with an activity many would not consider a sport—cheerleading. Dr. Andrews notes that there are over 3.5 million cheerleaders in the United States, and that with “the complexity and competitive nature that cheerleading has developed, both the injury rates and the potential for severe injury have increased.” In fact, Dr. Andrews notes that “the total health insurance costs associated with collegiate cheerleading make up fully 25 percent of the overall medical costs.” (Football takes up 57%.)

Dr. Andrews also addresses a number of popular myths regarding sports medicine, notably the idea that surgery can improve athletic performance. He notes that many young pitchers believe Tommy John surgery will improve their throwing arms. In fact, he says, the reason pitchers tend to improve following surgery is the subsequent rehabilitation, where the player can “work his arm in a controlled, carefully supervised and monitored environment” thereby avoiding the fatigue associated with normal in-season practices.

Another myth, according to Dr. Andrews, is that there is adequate medical supervision at the lower levels of organized sports. While SEC schools can afford the best care for football players, “At the high school level, general athletic trainers are usually not available for all of the sports, and there are not always emergency medical teams present at games and competitions.” Paradoxically, the doctor notes,

[I]f more medical resources were made available to children when they were younger, the need for such extensive treatment options at the professional level would greatly decrease because the athletes would already know how to protect their bodies and recover from injuries, and they would not be working around the ambient pain from older injuries. The upside-down medical care for athletes should not be turned around to favor the young who are, unfortunately, more vulnerable to injury due to their developing bodies.

Dr. Andrews calls for stricter standards such as certified medical trainers in all public schools. He doesn’t get into how to pay for such care, which is beyond the scope of this book. However, as the concussion issue continues to worm its way through the courts—and eventually impact college and high school football, not just the NFL—the sports medicine community may find itself even further deprived of resources as scarce capital is allocated to class action lawyers and so-called expert witnesses.

Dr. Andrews generally avoids discussion of legal and political issues in Any Given Monday aside from a brief chapter on Title IX. He laments the “unforeseen negative consequences” of schools cutting men’s sports programs to meet federal gender-parity mandates. He says the law fails to account for the “varying degrees of interest in sports” (emphasis his), and that parents should take an active interest in learning about their children’s schools’ Title IX policies to ensure men’s teams aren’t unfairly eliminated.

Indeed, parental responsibility is the overriding theme of Any Given Monday. He says that parents not only have to be able to identify symptoms of serious injury, but also know when their children are simply tired of playing a particular sport. Dr. Andrews says that many of his younger patients actually research injuries and fake symptoms in order to get out of practice rather than confront their parents. As we all know, the majority of high school athletes will never play at the SEC or NFL level, and excessive parental pressure may increase the risk of injury, negating the general health benefits of playing a sport in the first place.

These are all common-sense observations, but coming from someone of Dr. Andrews’ stature it should resonate with most parents. More than anything, Any Given Monday provides useful medical context for the ongoing football concussion “epidemic.” Dr. Andrews explains that every sport involves risk of serious injury and that, particularly for high school and younger athletes, there’s no substitute for parental vigilance. That’s an important message in the current climate, where lawyers and their media lackeys want you to believe that litigation and long-winded columns about the horrors of football are the solution.

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Dr. James R. Andrews with Don Yaeger, Any Given Monday: Sports Injuries and How to Prevent Them, for Athletes, Parents, and Coaches—Based on My Life in Sports Medicine, Scribner, 2013 (New York), 270 pages, available in hardcover and electronic form from Amazon.com.

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