Dr. Matthew Matava of the St. Louis Rams and the NFL President of the NFL Physicians Society has been practicing orthopedics for almost two decades and has written numerous papers on injury trends and findings relating to NFL athletes.
SportTechie: The NFL just came out with a study that says concussions are down 13 percent and ACL tears are also down. Is that due to policy or technology?
Dr. Matava: I would say it’s more due to policy based on the research and the evidence we have, with our medical based information. Technology is being used in two ways. First, there is the sideline tablet that we are able to use for psychological testing. It’s a 6-8 minute scan, with an objective, validated testing method, where the players are asked questions to do with memory, processing speed, recall, and balance. A score is then given based on their answers to those questions compared to their original baseline scores. This is a brand new technology that we’ve used this year for the first time. It’s been very helpful to objectively help us guide those concussions not only based on the player’s history but also through symptoms.
The other aspect of technology that has been very helpful is the sideline video monitor. This has been installed such that the head physician and the athletic trainer can review a play and see where the player was hit, how he twisted, how he was struck, etc. In the past, we’ve relied on whatever replay was shown, but now we can see the same TV feed the fans see with different angles, slow motion, and watch as many times as we want to hone in on exactly what we are looking for on a particular injury.
SportTechie: What are some of the challenges you face with a much more intricate protocol on the sidelines?
Dr. Matava: We have to have the players buying into it and being honest with us about their symptoms. We know they want to play and get out on the field, especially for a big game like the Super Bowl. But, we count on their input as well to let us know when they’ve had an injury or when they have symptoms of pain or dizziness – things we might not be able to tell from a normal discussion.
These new technological innovations will allow us to diagnose concussions even when there are no symptoms to report.
SportTechie: We have written many articles on head injuries and new anti-concussion technology. Does knowing that so many people are interested in a solution make you believe things will get better?
Dr. Matava: Sure we are. Medicine evolves in every aspect. Where were we 20 years ago without an MRI? In 1983 I have a 14-inch scar on my knee. Now a patient’s operation it takes an hour to do with a one or two inch incision.
Of course, technology is going to help with something as complicated as the brain. We still have a good imaging modality where we can quickly and accurately discern what kind of injury it was, i.e. a concussion and how severe it was, and then hopefully correlate that severity with the prognosis of time when they can return to play. Hopefully we’ll know which players or which injuries are more prone to long term consequences.
Nowhere in sports medicine has the topic of concussions endured so much research and interest, and the NFL has led the way in that regard.
SportTechie: What are some of the most important technological advancements in sports orthopedics in the last 10 years?
Dr. Matava: An area where technology has really helped us is with cartilage reconstruction. Cartilage replacement is sort of the holy grail of sports medicine in terms of knees and shoulders. We can’t replicate normal cartilage so there is a lot of active research in that field.
SportTechie: How valuable is the combine? Is its only real purpose to medically examine the players?
Dr. Matava: Call me bias, but I think the biggest benefit of the combine is medical. Yes, they take the Wonderlic test, and yes, they interview with the coaches, run the 40-yard dash and do various other position drills. But, there is no other area of society where a player will get six physical examinations in one day. In each medical room, there are six teams represented. Players then go from room to room. Every one of the 32 teams can evaluate each player and if somebody picks up something in one room, they’re free to order whatever tests they want to, to further evaluate.
At the end of the whole process, a player might have five or six MRIs or X-Rays ordered. There’s no more thorough evaluation from a medical perspective
SportTechie: How important are playing surfaces to the health and injury of players?
Dr. Matava: If you can recall the days of astroturf, it was like playing on concrete. That was associated with twisting ligaments and injuries to the joints because the foot planted to hardly that they wore a basketball type shoe. It was a lot harder then grass, so when you hit your head, there were concussion risks
With field turf, it’s soft but it still doesn’t replicate normal grass. We have had research published through the NFL Physicians Society that shows the risk of ACL tears and high ankle sprains are higher on synthetic surfaces then it is on natural grass. I don’t know one player who told me he feels better at the end of the game on artificial surfaced compared to natural grass.
SportTechie: How will EMR (Electronic Medial Records) impact the way that you and your colleagues do their job?
Dr. Matava: It’s going to be huge. Just like your personal physician will be able to know what’s going on with you, electronically, we will too on the sidelines.
I say sidelines because with the new tablets that will be available will contain concussions software, and will have players’ past medical history and records. We’ll know the medications he’s on, what allergies he has, and what previous surgeries he’s had. You know being in the tech industry how much smarter we are going to be with this handheld device at our disposal.
SportTechie: What’s next in the field of sports medicine technology?
Dr. Matava: We’ll continue to get better in terms of equipment. I think the playing surface is going to improve, hopefully reducing the number of injuries to the lower extremities. I think technology will help diagnose injuries to the brain with imaging and potentially a blood test that will give us an idea of the presence and severity of a concussion.
Technology will also help with cartilage injuries, which we haven’t quite gotten yet to what is natural. These are the two things over the next ten years that will really impact athletes or even the weekend warrior.