The Injuries That Changed Sports Forever dr. david geier Dr. David Geier
That’s Gotta Hurt The Injuries That Changed Sports Forever
ForeEdge
Uncorrected Page Proof copyrighted material
Geier_1stpgs.indd 3 2/7/17 12:27 PM ForeEdge An imprint of University Press of New England www.upne.com © 2017 Dr. David Geier All rights reserved Manufactured in the United States of America Designed by Mindy Basinger Hill Typeset in Minion Pro
For permission to reproduce any of the material in this book, contact Permissions, University Press of New England, One Court Street, Suite 250, Lebanon NH 03766; or visit www.upne.com
<
5 4 3 2 1
Uncorrected Page Proof copyrighted material
Geier_1stpgs.indd 4 2/7/17 12:27 PM Introduction
March 7, 1970
“I realized that something was wrong,” Bogataj would recall years later to Phil- adelphia Daily News columnist Rich Hofman. “I tried not to go, tried to stop myself. But the speed was too big, about 105 kilometers an hour [roughly 65 miles per hour]. So I did everything I was able to do.” You might not know the name Vinko Bogataj, but you know who he is—or at least you know his crash. Earlier that day, Bogataj had lef the chain factory in Yugoslavia where he worked, along with his three friends, to drive to Oberstdorf, West Germany. Growing up on a farm in a family with eight children, the 22-year-old set out on that snowy day to compete in a passion of his: ski fying. Despite working full time, Bogataj was fairly accomplished in the sport that would later become known as ski jumping. He competed more for fun than prize winnings, as his greatest career “paydays” included $200, a stove, and a color television. Little did he know as he set out for Oberstdorf that he would soon become famous—or infamous—depending on one’s perspective. Having already fallen once, Bogataj faced worsening weather conditions heading into his second jump. Now he faced swirling winds and new snow on the ramp. Race ofcials shortened the jump out of safety concerns. “Tese days, they wouldn’t even compete in those conditions,” Bogataj told Dave Seminara of Real Clear Sports 40 years later. Bogataj sped down the ramp, but he lost his balance before he reached the end of the platform. He placed his right hand down, but his legs gave way. He fipped of the side of the jump in a spectacular fashion. He somersaulted through the air, ripping through a sign that read OBERSTDORF at the bottom of the ramp, and nearly crashing into nearby broadcasters, spectators, and race ofcials. “I could’ve gotten up, I didn’t feel hurt, but they wouldn’t let me,” Bogataj told Seminara. “Tey insisted on carrying me of on a stretcher, which I wasn’t happy about because my family was watching on TV.”
Uncorrected Page Proof copyrighted material
Geier_1stpgs.indd 1 2/7/17 12:27 PM His family would soon learn that Vinko would be fne, despite crashing at over 60 mph. Bogataj told Hofman that the violent appearance of what happened had scared the medical staf and onlookers. “I didn’t feel any pain at frst. I was just angry it happened. People kept telling me that it had to hurt. It looked so dangerous.” Te video footage of that dangerous crash would immortalize Vinko Bogataj. As he would ask in a ceremony to honor the 25th anniversary of the show on which Bogataj’s crash was broadcast, legendary sports host Jim McKay asked the audience, “Do you know this man? Probably not. He doesn’t even own a credit card.”
Each Saturday for 37 years, Wide World of Sports opened the same way. It fea- tured video clips of a variety of athletic competitions to an instrumental musical fanfare. Host Jim McKay read a narration that became timeless:
Spanning the globe to bring you the constant variety of sport. Te thrill of victory and the agony of defeat. Te human drama of athletic competition. Tis is ABC’s “Wide World of Sports.”
Vinko Bogataj and his spectacular crash were “the agony of defeat.” When Wide World of Sports frst aired in 1961, producers ran footage of Irish hurlers colliding during “the agony of defeat.” In 1970 Dennis Lewin, the coordinating producer for Wild World of Sports between 1966 and 1996, and executive producer Roone Arledge decided to pair Bogataj’s crash footage with the words “agony of defeat.” Despite frequently changing the clips throughout the remainder of the open- ing montage, the show kept the footage of Vinko Bogataj to represent “the agony of defeat” for the next 28 years. It is difcult to imagine anyone thinking of Wild World of Sports without recalling Bogataj spinning wildly of the ski ramp in Oberstdorf, West Germany. Not everyone appreciated that fact, though. Doug Wilson produced the show in Oberstdorf for ABC. He recalled that leaders in the sport of ski jumping were never particularly happy about Bogataj’s crash being prominently featured in the Wide World of Sports opening montage. Tey believed it created a ripple efect week afer week, causing hesitation among athletes considering the sport. Ken Anderson, founder of the website SkiJumpingUSA.com and a former ski
2 / Tat’s Gotta Hurt Uncorrected Page Proof copyrighted material
Geier_1stpgs.indd 2 2/7/17 12:27 PM jumper himself, argued that ski jumping has never recovered from the damage inficted by the Wide World of Sports opening montage. “Well, absolutely,” Anderson said about the damage done by that footage. “It’s a well-known sport everywhere else in the sports world, but in North America, the U.S. and Canada, it’s not a sport that is very well known. Because people see something like that, that becomes their whole perception. Tey don’t see much of the sport. It’s poorly covered here, so that’s all they know about it. It defnitely afected recruiting.” According to Anderson, ski jumping has struggled in the United States for reasons other than the Wide World of Sports footage. Only a few sites maintained their jumping facilities, and most eventually closed them. Only a handful of ski-jumping clubs currently exist in the country. Tey are spread out across the United States, so young athletes rarely compete against each other. Travel costs for competitive jumpers, a lack of recreational participants, and the growth of winter sports like snowboarding and freestyle skiing have all contributed to the sport’s decline. Despite the widespread perception that ski jumping is dangerous, Anderson argues that it is a safe sport. He notes that a study by the International Ski Feder- ation (Fédération Internationale de Ski, FIS) tracked six snow sport disciplines, including Alpine, freestyle, snowboard, ski jumping, Nordic combine, and cross country, and according to the FIS Injury Surveillance System, only cross-country skiing is safer than ski jumping. “ABC never did a good job of saying, ‘Yeah, but he wasn’t really seriously hurt, and he went back to jumping.’ Tey just lef it there, lef it hanging and let people’s perceptions be whatever they might be,” Anderson complained. Wilson recognized the value of the crash footage. “Instantaneously, as it happened, I thought it would be a great ‘Agony of Defeat.’” He pointed out that Bogataj “could have been very, very badly hurt. If that had happened, it would have been inappropriate to show week afer week as the ‘Agony of Defeat.’”
Tat’s Gotta Hurt examines the intersection of sports and medicine over the last 50 years. While millions of people have seen the footage of Vinko Bogataj’s ski-jumping crash, few viewers saw its outcome. Aides carried the Yugoslav jumper away on a sled and transported him to a local hospital, where he was admitted overnight. Amazingly, Bogataj sufered only a mild concussion. Te video of that high-speed trauma, though, might have changed a sport forever. In the ensuing chapters, I explore a series of injuries that changed their
Uncorrected Page Proof Introduction / 3 copyrighted material
Geier_1stpgs.indd 3 2/7/17 12:27 PM sports—or sports in general—forever. I examine how emerging surgeries, treat- ments, and prevention strategies afected athletes in many sports. I discuss how sports medicine has had a tremendous infuence on athletes and sports—perhaps more than any change in coaching or training has had. I also examine how sports medicine will continue to infuence sports and the athletes who play them for years to come. It would be fair to say that sports and medicine have always been closely as- sociated. In a 1984 article in the American Journal of Sports Medicine, George A. Snook, MD, presented a thorough review of the history of sports medicine from ancient Greece to the mid-1900s. He asserted that the frst recorded sporting competition, the frst incident of rule breaking, and the frst sports injury were described in the book of Genesis:
And Jacob was lef alone; and there wrestled a man with him until the breaking of the day. And when (the man) saw that he prevailed not against (Jacob), he touched the hollow of his thigh; and the hollow of Jacob’s thigh was out of joint as he wrestled with him.
In the second century AD, Galen of Pergamon, a prominent surgeon and philosopher of the Roman Empire, was appointed as the frst “team physician.” Pontifex Maximus appointed Galen to serve as physician to the gladiators. He was reappointed to that position fve times. He later served as physician to Emperor Marcus Aurelius. During his career, Galen performed extensive anatomical dissections and physiology research, publishing numerous works. Sports medicine likely owes its American origins to Amherst College. In 1854 Edward Hitchcock, MD, became Amherst’s frst instructor of physical education and hygiene. Dr. Hitchcock created a physical education system that included running, basketball, and baseball, earning him the label “father of physical education.” He collected data on sports, diseases, and injuries at the college, publishing a textbook and well over 100 articles. As such, it’s fair to say he was America’s frst sports medicine physician and team doctor. In the early 20th century the sport of football faced intense scrutiny for its high injury rate. Te government considered banning the sport altogether. Dr. Edward Nichols published two papers on injuries in football, one in 1905 and a second in 1909 afer the National Collegiate Athletic Association (NCAA) adopted changes to its rules to make the sport safer. Nichols’s work largely helped to save football.
4 / Tat’s Gotta Hurt Uncorrected Page Proof copyrighted material
Geier_1stpgs.indd 4 2/7/17 12:27 PM Dr. Mal Stevens played football at Yale University and later became the team’s head coach. Stevens coached football during medical school and while working as an intern, resident, and fellow. He later became president of the American College Football Coaches Association and coauthored a textbook on football injuries. In that work, he advocated pneumatic padding in football helmets. Stevens later became the team physician for the New York Yankees. Dr. Augustus Torndike of Harvard University published what is considered to be the frst American sports medicine textbook in 1938, Athletic Injuries: Prevention, Diagnosis, and Treatment. Harvard developed a model for athletic care that largely represents the modern sports medicine team. Harvard’s sports teams had team physicians, athletic trainers, and therapists to treat and reha- bilitate injuries and educate the athletes about proper ftness and equipment. Another key member of the Harvard faculty, Dr. Tomas B. Quigley, served on the American Medical Association’s Committee on the Medical Aspects of Sports. As the committee’s chair, he helped to publish “Te Bill of Rights for the College Athlete,” which pushed for preseason physicals, doctors at sporting events, and physicians being closely involved in the care of the athletes. Dr. Quigley emphasized the need for quality equipment, facilities, ofciating, and coaching. He stressed that the medical needs of the athlete should take prece- dence over any other concerns. From gladiators in ancient times to gladiators on the gridiron, we know that injuries occur. As Dr. Quigley explained whenever asked about his interest in sports medicine, “Whenever young men gather regularly on green autumn felds, or winter ice, or polished wooden foors to dispute the physical possession and position of various leather and rubber objects according to certain rules, sooner or later somebody is going to get hurt.”
Wide World of Sports aired from 1961 to 1998. Te program usually featured sports other than mainstream American sports like football and baseball. In- stead, it featured Olympic sports such as skiing and fgure skating as well as less traditional sports such as Mexican clif diving, powerlifing, and frefghters’ competitions. Te show frst broadcast sports competitions that went on to become note- worthy in their own right. Wimbledon, the British Open, the Daytona 500, the Indianapolis 500, and the Little League World Series are just a few of the events frst broadcast on Wide World of Sports.
Uncorrected Page Proof Introduction / 5 copyrighted material
Geier_1stpgs.indd 5 2/7/17 12:27 PM As television coverage of sports exploded in the second half of the 20th century, broadcast and cable networks siphoned of much of the programming that had made Wide World of Sports habitual Saturday viewing for decades. Wide World of Sports alone did not cause the increasing prominence that sports acquired in American society, but it certainly accompanied that growth. A few statistics from diferent sports reveal how sports—and society—have changed since 1970, the year Vinko Bogataj crashed in West Germany. In 1970 the average player salary in Major League Baseball (MLB) was $29,303. Te game’s highest paid player, Willie Mays, earned $135,000 that season. Contrast those numbers with 2013, when the average salary reached $3.39 million, and Alex Rodriguez collected $29 million. Te Bufalo Braves National Basketball Association (NBA) franchise was founded in 1970. Te team moved to San Diego in 1978. Tree years later, Donald Sterling bought the San Diego Clippers for $12.5 million. Steve Ballmer bought the Los Angeles Clippers in the summer of 2014 for $2 billion. On January 11, 1970, approximately 44.3 million viewers in the United States watched the Kansas City Chiefs defeat the Minnesota Vikings in Super Bowl IV. Approximately 111.5 million people tuned in to see the Seattle Seahawks crush the Denver Broncos in Super Bowl XLVIII on February 2, 2014. Many more kids play sports today than played decades ago. In fact, more than 1 million young athletes currently play high school football, and 2.58 mil- lion children between the ages of 6 and 14 played tackle football in the United States in 2013. As any National Football League (NFL) fan can tell you, injuries are a normal part of sports. It should be no surprise that along with the growing popularity of the athletes comes a heightened prominence for the doctors who treat their injuries. Doctors travel with their teams as they play all over the country. Tey obtain magnetic resonance images (MRIs) minutes afer injuries occur. Websites feature medical analysis of injuries and try to predict when athletes will return to play. And fans can rarely watch an hour of ESPN’s SportsCenter without hearing that a player will travel to undergo surgery by Dr. James Andrews. In fact, I will be doing an interview on SiriusXM Fantasy Sports Radio later today (on the day I am writing this introduction). We will discuss all of the injuries in the NFL this weekend: Robert Grifn III, Jamaal Charles, DeSean Jackson, A. J. Green, and others. Te fact that fantasy sports exist at all and are so popular—and that people
6 / Tat’s Gotta Hurt Uncorrected Page Proof copyrighted material
Geier_1stpgs.indd 6 2/7/17 12:27 PM want to hear from an orthopaedic surgeon to explain the injuries—shows how much sports and sports medicine have changed. Tat’s Gotta Hurt discusses the injuries that brought sports—and sports medicine—to where we are today. I examine key injuries that changed the athletes and subsequently the treat- ment of athletes and active individuals: Joan Benoit’s arthroscopic knee sur- gery 17 days before she competed in the US Olympic marathon trials; Bernard King’s anterior cruciate ligament (ACL) injury and unprecedented rehabilitation and return to sports; and Hines Ward’s use of a novel treatment—platelet-rich plasma—for a medial collateral ligament (MCL) injury of the knee days before playing in the Super Bowl. I also discuss injuries that changed their sports, leading to rules changes, adoption of protective equipment, or even calls for the elimination of the sport: the death of cricket star Phillip Hughes and severe injuries from the ball striking players in cricket and baseball; Marc Buoniconti’s quadriplegia afer a tackling injury and changes to decrease catastrophic cervical spine injuries; the death of freestyle skier Sarah Burke and snowmobiler Caleb Moore and the dangers of “extreme” sports; and Dave Duerson’s suicide and the role of concussions and repetitive subconcussive blows to the head, leading to chronic traumatic encephalopathy (CTE). Te discussion then turns to injuries that have impacted athletes and sports generally and will afect treatment of future athletes in all sports: Sam Bowie and the complex evaluation of athletes to try to predict whether they will stay healthy; Michael Jordan’s navicular fracture and the difcult issues that arise when trying to determine appropriate return to play for professional athletes; the sudden cardiac death of college basketball star Hank Gathers and the intense debate over mandatory cardiac screening of athletes; Minnesota Vikings tackle Korey Stringer’s death from exertional heat stroke; ACL injuries among Brandi Chastain, other members of the US Women’s National Soccer Team, and young female athletes generally, and the development of injury prevention programs to decrease them; and Tommy John’s landmark elbow surgery and the epidemic of youth pitching injuries decades later. I wrap up this journey by exploring what could lie ahead for sports and the feld of sports medicine, looking ahead not only to new treatments and preven- tion strategies, but also to where we could be headed in terms of ethics, legal dilemmas, and conficts of interest. And within this entire discussion of the infuence of sports medicine on
Uncorrected Page Proof Introduction / 7 copyrighted material
Geier_1stpgs.indd 7 2/7/17 12:27 PM sports—and vice versa—at the elite level, I show how these changes have in- fuenced and will continue to infuence the far more numerous youth athletes and adult weekend warriors.
Wide World of Sports remained a staple of American sports for 37 years. Te umbrella title ABC’s Wide World of Sports was used for a number of years afer that, so the footage of that crash in Oberstdorf remained in the opening montage decades afer the event happened. “Maybe it was 10 years later, about 1980, there was a suggestion that maybe it was time to replace Vinko’s fall,” Wilson recounted. “Roone Arledge, in his brilliance, sort of tugged at his sweater, as was his habit when he didn’t want something to happen or wanted to make a point. Basically he said, ‘Why are we doing that?’ What that meant was we shouldn’t do it, and we didn’t. It stayed in the rest of the history of Wide World. Tere was a moment where people were talking about replacing it, and Roone put a stop to that. He knew what he had. He had a signature thing. I mean, everybody remembers it. Everybody who ever watched the show. You mention the ‘Agony of Defeat,’ and people think of the ski jumper.” Bogataj became somewhat of a celebrity, although it was years before he re- alized it. “He found out that he was famous, or his fall was famous, in Oscar’s, the cofee shop in the Waldorf,” Wilson recalled. “We brought him over with an interpreter and his wife, and put them up in the Waldorf. He was a forklif driver in an iron foundry in Yugoslavia. He was speaking Serbo-Croatian in the cofee shop, and some of the waiters coincidentally in Oscar’s were Serbo-Croatian. Tey don’t normally hear their language, so when they stopped and they heard that language, they inquired. When they found out who he was, they went nuts. Tey went over to the restaurant saying, ‘See the guy in the booth there? He’s the ‘Agony of Defeat.’” We might not remember Vinko Bogataj by name, but we will always remem- ber “the agony of defeat” guy. In fact, at the 20th anniversary celebration for Wide World of Sports in 1981, Bogataj received a standing ovation and the loudest applause, more than Nadia Comaneci and the 1980 US Olympic hockey team. Muhammad Ali asked Bogataj for his autograph. Vinko Bogataj has settled back into his life as a forklif operator and a painter in Lesce, Slovenia. Despite his relative “fame,” he hopes that athletes take home one message from watching his crash: “Every time you fall, you have to get back up.”
8 / Tat’s Gotta Hurt Uncorrected Page Proof copyrighted material
Geier_1stpgs.indd 8 2/7/17 12:27 PM About the Author
Dr. David Geier is an orthopaedic surgeon and sports medicine specialist who provides education and commentary on sports and exercise injuries to athletes and active people to help them stay healthy and perform their best. Afer spending eight years serving as director of sports medicine at an aca- demic medical center, he lef to start his own practice. He currently serves as medical director of sports medicine at a private hospital outside of Charleston, South Carolina. He holds a board certifcation from the American Board of Or- thopaedic Surgery in orthopaedic surgery as well as a subspecialty certifcation in orthopaedic sports medicine. Currently he serves as the Communications Council chair for the American Orthopaedic Society for Sports Medicine (AOSSM) Board of Directors. He also serves as chairman of the publications committee for AOSSM. He serves on the outreach committee for the STOP Sports Injuries campaign and the medical aspects of sports committee for the South Carolina Medical Association. He has previously served as the chairman of the public relations committee for AOSSM and as a member of the sports medicine evaluation committee for the American Academy of Orthopaedic Surgeons. He started writing articles on his website—DrDavidGeier.com—in August 2010 as a hobby. His goal at the time was simple: to share sports medicine and wellness information in easy-to-understand language for athletes, parents, coaches, and other health-care providers. What he never expected to fnd back in 2010 was a passion for communicating this information. Despite long hours in clinic and surgery, he is still excited to open his laptop and write. He now writes a regular column for the daily Charles- ton newspaper, Te Post and Courier. He records videos every week answering questions from his audience, and he produces a weekly sports medicine podcast. He also created a networking and educational site for health-care professionals who work with athletes and active people, Sports Medicine University. As of this writing, over 200,000 unique visitors come to his website every month. For more information about Dr. Geier, or for more information on sports and exercise injuries and injury treatments and prevention, check out DrDavidGeier. com and his Sports Medicine Simplifed online courses.
Uncorrected Page Proof copyrighted material Geier_1stpgs.indd 301 1/17/17 3:15 PM