This week on The Conversation, we are honored to have with us Dr. Kevin Kaplan, an orthopedic surgeon at JOI Fellowship in Sport medicine expert and also the head physician for the Jacksonville Jaguars. It’s a very interesting episode where he talks about how the players are checked up for health problems and the process of sport medicine — from the draft all way to the final game.
Jay Gray: Good afternoon and welcome to The Conversation on News Talk WOKV. Thanks for joining us, I’m Jay Gray joined here by Dr. Ali Kasraeian. Doctor, what do we have on The Conversation for today?
Dr. Ali Kasraeian: So today we have my good friend actually from since high school Dr. Kevin Kaplan who is an orthopedic surgeon at JOI Fellowship in Sport medicine expert and also the head physician for the Jacksonville Jaguars, to talk to us a little bit about the mysteries behind the medicine that goes on at the combine, during the draft and even on the sidelines. Nothing specific but general details on what’s going on. Thanks for joining us today.
Dr. Kevin Kaplan: Thanks for having me, it’s good to be here.
Dr. Ali Kasraeian: So Jay do you have anything to start out with for today since you’re the big sports guy?
Jay Gray: Yeah my knees are hurting right now, can you tell me why?
Dr. Kevin Kaplan: We can fix that.
Jay Gray: That will be great. But you know it’s always curious because you see guys that are projected to be huge coming out of the draft but then for some unknown reason, they say: “you know what, this guy we see injury problems in the future.” How can you see that so far in advance? This is the guy that will have some injury problems with the knees, the legs, something is not right about him and he falls two, three rounds.
Dr. Kevin Kaplan: That’s the beauty part of about the whole combine experience. We sit in a room and literally every year with the same team and our room happens to be us, the Titans, the Jets, the Bengals, the Chargers. And we’re in a big room and every player that goes into the combine comes in, and we get X-rays, MRIs, CT scans — any test that you can possibly imagine. And we go through and examine these guys and we say is there a risk here, and is there something that we’re seeing to worry about the guy’s injury in the future.
Dr. Ali Kasraeian: So how does the process begin?
Dr. Kevin Kaplan: So, the combines actually started, it was in the whole show of the 40 yard dash and the vertical leap and all that stuff. It was just doctors getting together to meet the players before they recommended the team — this guy is going to be healthy, this guy is going to have a long career, and so then it obviously turned into a show. It’s the NFL, so there’s going to be a song and dance and that’s what you guys see–
Jay Gray: I love it. I watch it every year on NFL network. Every year, I’m just sitting there watching every 40 yard dash and you would think that it’d be pretty boring. That is actually kinda of exciting.
Dr. Kevin Kaplan: We’re down in the dungeon and basically big players come in and the register, and there is a medical side and there is a orthopedic side and we have our medical doctors with the rest of the teams and the rest of the teams have their doctors looking at their heart and lungs missing any cardiac abnormalities, or big red flags these guys are at risk for playing. And they go through those rooms and they come in to our rooms and everybody gets a feel. If a guy had an ACL reconstruction, you want to feel that knee, you want to know what it feels like, is it solid, is it tight, is there arthritis in the knee already and so these players go through and we give them a medical grade risk. That’s how we have a discussion with our staff when it comes to draft time and they look at me and say, “what do you think?” and I got to have an opinion
Dr. Ali Kasraeian: I tell ya the interesting thing I found reading over this is that players can come in and refuse to do their work outs, you know the things people like to watch on TV but they absolutely cannot refuse their medical tests.
Dr. Kevin Kaplan: Correct. Some guys don’t want, whether it be a quarterback who does not want to throw, not in his environment with his players or doesn’t want to do the bench because he hasn’t worked out or doesn’t feel that it’s important. But medical stuff is what the core of what the combine is about and you can’t refuse those things. These guys want to know what their health status is.
Dr. Ali Kasraeian: It reminds me of one of my friend from medical school, a really sharp guy, one or two in our class. He had his personality, he didn’t think was his shining point of his resume so he actually didn’t do any away rotations or what are called externships during his 4th year because if I show up it’s going to ruin my application.
Jay Gray: Could make or break you, it’s true. That is very true.
Dr. Ali Kasraeian: So I guess it’s kind of a safe thing. So as a day begins, one thing I notice is that they break players down by day. So, one of things I looked up said the first day is offensive line, the punters and the kickers and the quarterbacks, the running backs, tight ends and line receiver, the line backs, the quarterbacks and save these for a four-day process. One, why is that? And two, do you look at these players differently based on the positions they are playing now and hope to play in the future?
Dr. Kevin Kaplan: That’s a great question. In terms of looking at these guys, obviously there are certain positions that are at greater risk at certain things. You look at offensive line men and defensive line men that are pushing all the time. You want to look at the shoulders, their posterior labrum or that cartilage in that shoulder. You want to look at their backs, do they have degenerative backs. where as the speed guys, you want to look at their feet, their knees. You want to look at their knees and so, the idea is we have a certain mindset with certain guys. If they bring them all at once, you are in that same mindset where as if they brought in an offensive lineman you’re looking at their back, then a wide receiver you are looking at his knees, and so it kind of brings it all together when we’re looking through our list of guys.
Dr. Ali Kasraeian: It’s interesting, I found the only test that requires imaging is the X-ray of the lumbar spine for the line men because of the wear and tear on their lower spine because of what their body handles and what they end up doing.
Dr. Kevin Kaplan: Body habit is that they get pushed on all the time so the disc on their back is just getting worn on.
Dr. Ali Kasraeian: So let me ask you kinda taking it back, how did you get started doing orthopedics in the first place? You know all my friends who had orthopedics including my brother who is a sports medicine guy who focuses on extreme sports — as he’s Californian — by nature–
Jay Gray: Just saw him the other week.
Dr. Ali Kasraeian: So with people have injuries, they start following their doctor around or something of that nature, what is your tale that took you to orthopedics?
Dr. Kevin Kaplan: So in Jacksonville I broke my leg at the age of 13 and I actually wanted to be a physical therapist. And Dr. Ripley, I don’t know if you know him, and one of my partners now Dr. Hardy and that same group Dr. Shirley, who was in that group at the time and Dr. Ripley, took me in and said, “Hey, if you are ever interested in orthopedics, come watch a surgery.” And I watched one knee scope after that and that was just my goal. I wanted to do that. I never lost sight of that.
Dr. Ali Kasraeian: So how did you know when you were doing orthopedic residency, ‘cos orthopedics can be very sub-specialized. How did you decide sports?
Dr. Kevin Kaplan: I guess I just liked sports. Watching sports and obviously played sports in high school and then in college. It was something that… I like the patient population. It’s the athletes, whether it be professional athlete, or the collegiate or high school athlete or us. Weekend warriors like us who probably shouldn’t be playing sports but still are and that population. That population wants to get better and wants to do well and so there is a problem whether it be a knee or a miniscus or a rotator cuff for something you can address and see these patients back in your office and get better.
Dr. Ali Kasraeian: One thing that’s amazing about orthopedics is that you are dealing with a patient population that is really motivated with sports to get back and get better so that’s a fantastic patient population to deal with, and it’s very rewarding.
Dr. Kevin Kaplan: Extremely rewarding. You see these people when they come back and they are not able to do something and you are able to address it, whether it’s surgical or non-surgical, or just rehab, and just be able to get back to their normal daily activities. I enjoy doing crossfit and still playing volleyball once in a while and if I could not do those things, it’s a major impact. We were talking about having kids and how it changes your life, and if you’re going to have that outlet working out or blowing off some steam and that really changes your lifestyle.
Dr. Ali Kasraeian: Let me ask you about crossfit, my brother said it’s a very good way to get into an orthopedic surgeon’s office. (Laughter)
Dr. Kevin Kaplan: It depends on who you are doing crossfit with. I work cross training in St. Mark. Those guys are fantastic.
Dr. Ali Kasraeian: It’s interesting, I live downtown in the St. Mark area as well and I was driving around a couple of years ago, when crossfit was just beginning, and as I was driving home there were all these people pushing these giant tractor tires around and I’m like, “what on earth is going on?” And I kinda looked around and they’re all in this gym and half of them were pushing these tires around and I got home and that night there was something on those channels talking about how crossfit is the greatest thing to do. So I can’t imagine for the weekend warrior if it’s the greatest thing to begin with.
Jay Gray: I’m a power lifter so power lifters and crossfitters don’t get along. Really don’t!
Dr. Ali Kasraeian: We should talk about that?
Jay Gray: I think mine’s the best, crossfitters think they’re the best. We probably shouldn’t get into it.
Dr. Ali Kasraeian: If there any crossfitters who want to debate with Jay about whichever is the best give us a call. (Laughter). As someone who is coming to your room and in the combine, what kind of process of how this plays into the draft and what the medical grade is your stamp of approval that this person has a lower risk of having injuries in the future because the coaches and the owner of the team are making a huge investment in these players. What is going through your mind as you’re seeing someone that comes in and first of all, talk about who is healthy.
Dr. Kevin Kaplan: So the combines to me, you know when you see a patient in your office they’re not really… they’ll come in and tell you their problem. It’s very much an interaction between the two. When you see these guys in the combines, a lot of it is detective medicine almost trying to learn [Dr. Ali Kasraeian: Sure, because they don’t want to tell you] you know, everybody is healthy. So for me, when players come in the room, I want to be able to determine what their risk is, what their injury has been in the past. A healthy guy that comes in, whether it is you know… a lot of the punters, the kickers tend to be the healthiest guys in the draft and you want to get an assessment of their position so obviously with kickers you’re looking at their knees, their hips, their feet and you want to do an overall basic exam.
Dr. Ali Kasraeian: Probably used to be soccer players, so they are incredibly fit ‘cos they are the healthiest athletes in the sports world if you ask me.
Dr. Kevin Kaplan: So the doctors… all of the teams have doctors there and athletic trainers and you know it’s very collegial — we’ll have discussions and they’ll have X-rays on the board and you want to get a sense whether or not they’re under risk and they’re great, It is not just a pass-fail. Every team has their own grade. We try to break it down as high risk, medium risk, low risk and no risk type of thing and they’re not numbers etcetera, but when it comes to guys that are not healthy and it’s obviously very hard to predict the future.
Dr. Ali Kasraeian: How… and we’re talking about two directions, one, the physician aspect of it but when the players with injuries do come in what is the interaction like. I assume it’s a very difficult day for them knowing they are coming in with an injury that is going to be scrutinized and may potentially impact their future as a professional athlete.
Dr. Kevin Kaplan: It’s very interesting seeing guys come in to our room and our room is the first room they come in and they have this look of bewilderment. They have guys circling around them feeling their shoulders. One guy is on their shoulder, one guy is on the knee, one guy is on the hip and they almost… a lot of the guys, they feel like a piece of meat right now trying to get pushed and poked on. The most interesting thing is when guys don’t know they have an injury and an injury is picked up on the combines. Stress fracture, let’s say, and that will really blow their mind because they went from, “hey I’m in the draft” or “I’m in the combines” to “wow I maybe need to have surgery before I can even play because these guys don’t want to tell me I’m healthy.”
Dr. Ali Kasraeian: What are some injuries that you as an orthopedic surgeon would absolutely disqualify someone from either participating in combines or even participating in the drafts?
Dr. Kevin Kaplan: Well things like that. Broken bones obviously, ligament tears and those are few and far between. A lot of the stuff you hear about on TV and in the news have to do with the medical side of things that cardiomyopathies. A lot of the orthopedic injuries really aren’t disqualifications unless it’s something like a fracture. But the higher risk things you worry about are the arthritis and the knees breaking down and things like that. So a lot of it is just a grade of risk. You are not fit to play football. Most of these guys have played straight through their college career.
Dr. Ali Kasraeian: Sure, now what about someone who is a high profile person who comes in with a high profile injury that’s in whatever stage of recovery?
Dr. Kevin Kaplan: A lot of these guys… this coming weekend I’m actually going back on Friday for one day for what’s called a Combine re-check. So for a lot of guys who weren’t able to or we were watching injuries back when we did the combine several months ago, now we’re bringing those guys back and all the doctors sit and wonder whom, and look at these guys again. So we pull these guys out if they have injuries or recovering from injuries.
Dr. Ali Kasraeian: Who is picked to come in to the Jaguar room? For example, is it all 300 some–
Dr. Kevin Kaplan: Every single guy. So we see 80-90 guys a day which wears on my back and my knees when I’m lifting up 300 pound guy’s legs. [Dr. Ali Kasraeian: And you go to every room?] Six rooms, and every team is represented and so they get poked and prodded on by every team.
Dr. Ali Kasraeian: How different are the evaluations between teams? Do you guys get in, as the physicians get in there and think “I thought this, I thought that” and the rooms have different or the teams have different results?
Dr. Kevin Kaplan: There are different ways to do it in the rooms. How we do it, we have one room, one table on the middle and we have fellows in the back are doing the initial histories and they’ll bring each guy up and say this guy is so-and-so, he’s had this injury, this injury and usually the player will come up and it’s very collegial. I mean these guys we’re all physicians and even though it’s Jets versus Jaguar, when we’re doctors sitting in the same room we’re all working together and evaluating these guys.
Dr. Ali Kasraeian: Very interesting.
Jay Gray: 340-1045, that’s the number to call at. Are you allowed to talk about any specific guys you saw or is that against the rules?
Dr. Kevin Kaplan: I can’t, I wish I could.
Dr. Ali Kasraeian: We can talk about my tryouts in the combine this year. It didn’t go very well but he checked me out then.
Jay Gray: Well if you have any generic questions, maybe you can beat around the bush about any players you saw at the combine. Give us a call 340-1045, the number to call in when we come back right here on The Conversation on News Talk WOKV.
Jay Gray: Welcome to The Conversation here on News Talk WOKV. Thanks for joining us. I’m Jay Gray joined here by Dr. Ali Kasraeian. 340-1045 that’s the number to call in. Aren’t talking a lot about NFL players, the combine issues, we can’t get too into specifics about the players but what about a guy like Zach Mettenberger, Aaron Murray — guys that are coming in to this year’s draft that already had pre-existing injuries. Do you look at them more or do you look at pretty much everyone equally across the board?
Dr. Kevin Kaplan: You look at everybody. Obviously, knowing injuries those guys will be re-checked like we said before but you look at them the same. You know what the injury is. You know how you deal with it and you can assess surgeries and what’s been done already and get a feel for the player, obviously without making a final decision but you kind of know when you re-check these guys and see them again.
Dr. Ali Kasraeian: Let me ask you, how long does this take? Because MRI scans are not quick studies, and for orthopedic injuries MRI scan is probably the most definitive radiographic imaging that you use and if you have 90 guys coming in, then a good portion of them need imaging and multiple imaging of different body parts. How long does this process take?
Dr. Kevin Kaplan: So Lucas Oil is an unbelievable stadium and it’s huge, and in the room right next to where we do our examinations they have huge trucks. Multiple, multiple trucks full of MRI machines. [Dr. Ali Kasraeian: Wow] So these guys are getting MRIs and some of them are scanning and when we look at some of the scans the next day we’re on the table like 1 in the morning or 2 in the morning. They’re going all the time– [Dr. Ali Kasraeian: Busy, busy couple of days for you] It’s unbelievable how they put it all together is truly unbelievable.
Dr. Ali Kasraeian: And it is a very cost-effective, healthcare reform friendly process [Laughter]
Dr. Kevin Kaplan: I need an MRI, CT scan… stuff that we wouldn’t get for weeks.
Dr. Ali Kasraeian: Interesting, interesting. Now let’s say the combine is over. You come back to Jacksonville, you sit down and look at the people who are injured. What’s the next step of taking the information, the data that you have gathered with your internal medicine colleagues and putting all that together?
Dr. Kevin Kaplan: So with our head team internal medicine doctor and then sit down with our athletic trainers and our athletic trainers are great and they are very organized. They’ll put together the folders with information. The NFL is actually gone to an electronic medical record system–
Dr. Ali Kasraeian: Fantastic, so you can web-based all the–
Dr. Kevin Kaplan: Web-based and a lot of the stuff we’re trying to do is make it easier for teams to share their information. So if a player comes in… if I want to get a CT scan, obviously that’s a decent amount of radiation on a player, if I can’t get that CT scan to another team then, now being on EMRs we can kind of share that information. So anyhow, we put together all that information into big books and I can go through everybody and see all the grades I have given so that I can be ready for drafting when it comes to sitting down and having the information for–
Dr. Ali Kasraeian: So after you give an initial score, or grade after the combine and you come back to Jacksonville to review everything with your team. Do they get a final score?
Dr. Kevin Kaplan: They may make changes depending on the updates. So our scouts are always out there looking at the players and if I want to see a guy who has had a hamstring strain and he’s back to normal then I can downgrade him or I can upgrade him based on the re-checks. So a lot of the changes will happen this weekend when I go look at these players again and see medically how they are doing. If they are better you can make him a lower risk or a higher risk. So yeah, it’s in flux until that draft time.
Dr. Ali Kasraeian: So when you go to draft day, what happens there?
Dr. Kevin Kaplan: So on draft day, on any kind of decision maker all I know are the medical side of things. So if they ask my opinion about a player then I have all that information from my examination from my grades that I can pass on to them.
Dr. Ali Kasraeian: So do you sit in the stadium for a day and a half while the draft is going on?
Dr. Kevin Kaplan: 8th, 9th and 10th — so yeah, those three days I’ll be there.
Dr. Ali Kasraeian: Interesting, interesting. So looks like we have a caller.
Jay Gray: You want to go to Patti or Tom? Which one would you rather go to?
Dr. Ali Kasraeian: Let’s go to Patti first. We’ll get to Tom on the flip-side.
Jay Gray: Patti, how you doing today from the south side, what’s going on?
Patti: Hi there, I wanted to make it really quick for you. We have a friend that’s a disabled veteran and he’s in his mid-sixties. He has a lot of pain in his knees, lower back. The VA is not helping us, so a group of us friends are going to get together and get the money together. The question is, what does an official office visit be? ‘Cos apparently we’re just going to pay cash for it to try to help our friend out to get an evaluation of what’s going to have to be done.
Dr. Kevin Kaplan: Well, that sounds like a tough issue. I can tell you that when it comes to stuff like that for insurance, with insurance obviously it can be an issue. We work with our financial team and we can do a self-pay and evaluation on giving you the best discount and making it the lowest cost as possible. I don’t have an exact number for you, but if you call our main line which is 346-3465 at JOI, we can try and work you through that so we can get him evaluated and make him better.
Dr. Ali Kasraeian: Patti, I hope you get the help you need for your friend. I tell you, you and your friend are very, very sweet for doing what you are doing. But it brings up an interesting point. As physicians, there’s a lot of things that have been in the media about Medicare data about how much physicians make we are seeing our patients we don’t really have direct access to this information because it’s not something in the forefront of our mind when we’re evaluating a patient in front of us.
Jay Gray: 340-1045 that’s the number to call in for The Conversation. We’re going to take a quick break, a quick update from FOX News, we’re having some pouring down rain earlier. It’s starting look a bit nice now but we’ll see how the Easter weekend forecast continues. Thanks for joining us on 104.5 FM and AM 690, News Talk WOKV.
Jay Gray: Welcome back to The Conversation here on News Talk WOKV. Thanks for joining us I’m Jay Gray joined here by Dr. Ali Kasraeian, 340-1045 that’s the number to call in. Going back to the phones with Tom. Tom, how are you doing today?
Tom: Hey guys, how are you?
Dr. Ali Kasraeian: Tom!
Tom: Hey! Sorry I couldn’t be in there.
Jay Gray: Yeah, I thought you were going to be here Tom?
Tom: Well I heard you’d come in so… so listen guys, Kevin, you and I have talked about this before–
Dr. Ali Kasraeian: Tom you’re breaking up.
Tom: Sorry guys, can you hear me any better?
Tom: Alright, let me stand out here. One of the things I had a question for is… what are some things that may hypothetically be disqualified… a draftee from being drafted. In other words, you look at them and then you go back to the coaches and you go: “Definitely not”.
Dr. Kevin Kaplan: So usually when it comes down to a lot of the things are to disqualify a player, meaning you cannot play football. Things you hear in the media coming out, guys that have rare heart issues, cardiomyopathies, things that would place their life at risk if they were to continue playing. Other things we worry about are active issues whether it be a broken bone, or stress fracture, you hear about guys all the time in the combines with a broken bone and something and they go on to have surgery. So, those are the risks. Other things are more longevity things in terms of risks. It’s really few and far between that I will say this guy cannot play the game of football. It does happen and most of those are really publicized in the media because of how rare that is, but yeah, when it comes down to it we’re physicians. All the physicians in the combines are doing the same thing for these athletes what we would be doing for our patients — what’s in the best interest of the guy’s health, is it okay for him to play and that’s the mindset I have. Is this guys safe, is he healthy and it’s important to know what the status is but we’ve got to keep the player’s health in mind.
Tom: I appreciate it. But basically somebody needing surgery or having surgery doesn’t necessarily scare you.
Dr. Kevin Kaplan: No. And guys in the past years and even this year and there are reports you probably even seen on ESPN guys that were caught at the combine with things they didn’t even know they had. It’s not our place, obviously we’re not their treating physicians, but these guys have agents and staff and they get their appropriate treatment, would it scare me? No, if anything we were helping these guys and granted, they probably made it through and did they have aches and pains, they didn’t realize they had stress fractures developing or whatever but these guys are talented and stress fracture and a dress isn’t going to prevent them from playing a game of football. If anything it’s going to prolong their career and make them get to where they want to go.
Tom: Thanks Dr. Kaplan, you guys take care!
Dr. Ali Kasraeian: Thank for the call Tom! So I tell ya I’ll take Tom’s comments to a different perspective. One, what are some maintenance things you do as the athletic training team and the physicians that take care of these patients to prevent injuries in the future and this may be something our weekend warriors, our high school athletes and people that are beginning college careers and things of that nature may take to heart in terms of good habits to try and prevent unnecessary injuries in the sport that is very prone to them?
Dr. Kevin Kaplan: So we have an unbelievable athletic training crew. It was Mike Ryan. Mike Ryan was the athletic trainer since the Jaguars inception. He recently retired which we’re going to miss him tremendously. We added on Scott Trulock who is from the University of North Carolina and Justin Bland and Rod Scott are our assistant athletic trainers and then our head strength and conditioning coach is Tom Luzinski who used to play for the Jaguars and these guys do an amazing job of taking care of our players. Both in the training room and in the strength and conditioning aspect. So these guys are constantly working out conditioning their bodies, they’re doing yoga, they’re stretching, they’re keeping limber. If you ever had a chance to tour the stadium. There are ice tanks Mr. Khan has put in for us and these guys will just sit in there with iPads with ice on their bodies down. So they’re on a regimented program. You can’t just go out there for that long and not expect to have minor injuries, and aches and pains. I always say that, I constantly say that to my office, treat yourself like a professional athlete. Get the stretch in there, the warm up, make sure you cool down, make sure you ice and treat your body right.
Dr. Ali Kasraeian: What are some things for the weekend warrior not to do?
Dr. Kevin Kaplan: I think as we all get older or mature as we should say, our tendons are getting tighter, our muscles are not getting as limber. We are prone to injure ourselves. I had a buddy, who shall remain nameless, who called me. I was getting on a plane to Miami and he said I played basketball with you together and I thought I could take this guy off the dribble and this guy hears a pop in his ankle. He tore his Achilles. [Dr. Ali Kasraeian: Wow] So it’s not going to happen to anybody but it’s important to get another and get a good warm up. You don’t to get out cold and start playing basketball like you are 16 years old. You could have done it then, but you can’t do it now. Stretching, breaking a sweat first, warming up and getting a jog in there to get the muscles moving, then you stretch and then you’re ready to get out there.
Dr. Ali Kasraeian: Very good. So limber up, get your blood moving and then stretch which again I tell ya most of the times back in the days when we were in school and doing our athletic team sports those general principles that we always did was do a couple of laps, stretch for about 20 minutes and then got back into practice or things of that nature. So those are good, good tips to take. Now, you get on the sidelines. What are the things if anyone is watching from the sidelines you are very intent, watching every play you’re seeing how you are progressing, what are the things you are looking for since there is a lot going on to pay attention to if you are trying to detect injury.
Dr. Kevin Kaplan: Absolutely and these guys are playing at the highest level of football and you have to constantly watch the field, watch the players and watch how they react because obviously the biggest thing in the NFL these days is concussion. So meeting these guys, I’m in the stadium Monday,s Wednesdays, Thursdays, you’re meeting the players, getting to know their personalities, get to know them ‘cos when things happen like a concussion, you want to be able to recognize that. You’re always watching these guys, how they move, get up, how they interact with other players and things are happening fast, it’s not like you have an ankle sprain that is see often and you say “hey man, we’ll ratchet it for four or six weeks and you will be okay”. These guys want to get out there and they want to get back quick. When an injury happens whether it’s on the pitch or on the sidelines, the assessment has to be made. Number 1, is this a severe game-ending injury or can this guy play, or how severe is it? And then you want to go forward from there. You get them with the athletic training staff, you run them through the motions and seeing if they can participate with whatever the injury may be. But obviously the most important thing that I’ve said before is the health of the player and can this guy get out there and protect himself and not injure himself.
Dr. Ali Kasraeian: You have mentioned concussions, we’ve done a couple of shows in the past about concussions it’s a very hot topic right now not just in the NFL but in high schools. A lot of guidelines in place that seem to be evolving to be more protective about the athlete to keep them out as long as they can so that you don’t have longterm impactful injuries. What are some things that have changed in your opinion over the few years you have done this on how concussions are viewed and managed?
Dr. Kevin Kaplan: So the good thing about concussions these days is that now if you have a concussion, you’re out. There is no, “can he return to play the same day?”. You’re done. The NFL has really gotten aggressive in terms of who is on the sidelines and if you look on the sidelines, there are a lot more doctors. Before the game, we always meet with the other team. The doctors meet on the field and go over everything. We have independent neurological consultants that are on both sidelines. So if a concussion happens, we can have those independent — they’re not with the team — they are independent, hired by the NFL to evaluate the player to see if he is safe to return to play. So in addition to our medical doctor who looks at concussions, we have this independent neurological consultant. In addition we have our own replay booth, so you will see in the sidelines behind our bench, in addition to the replay booth that’s down the way, we have our own replay booth and anybody can call. The independent consultant, we also have a spotter, that sits up in the booth who is watching the game with binoculars and we have radios in our ears and we can call down and say, player so-and-so took a hit, you may want to review him, look at him, review the play and go to our monitor and look at the play and then go talk to the player.
Dr. Ali Kasraeian: So who makes up the team? You mentioned there is an internal medicine doctor, an orthopedic surgeon, most often with a sports medicine background, if not always, an independent neurologist, I’ve read sometimes there is an ER physician, an anesthesiologist in case you need it intubate someone or put a breathing tube in place.
Dr. Kevin Kaplan: So the NFL did come down with a rule that you have to have a CAQ in sports specialty specific to be an NFL physician. Then we have our internal medicine doctors also CAQ and internal medicine sports medicine. The ER physicians if you look at the sidelines you’ll see a guy with a red hat on. That’s our physician who is there, god forbid, someone needs to be intubated on the field. He’s there, we have ENTs of the sidelines, we have our independent neurological consultants on our sidelines as well. And then we have our X-ray technicians who is there usually hanging in the back of the tunnel and if we need X-rays we have X-ray machines at the stadium.
Dr. Ali Kasraeian: You guys have CAT scan MRI at the stadium?
Dr. Kevin Kaplan: Only X-rays. We go to the hospital — which is close. And most teams do the same thing, so there is an X-ray always there. We’ll get X-rays before we leave or on the road, we want to know right away what’s the injury. A player, I think it was 3 or 4 years ago broke his leg and it was pretty severely broken and they left him here because he couldn’t fly the plane because you worry about swelling in the leg so you want to know these things before you can fly.
Dr. Ali Kasraeian: So how much time does this take you? You mentioned Mondays, Wednesdays, you’re at the stadium and then on the game days you fly away and on game day you’re here. How much of your time does it take to be a team physician?
Dr. Kevin Kaplan: I love doing it, it’s amazing and it is like a second job though. I’m there Monday morning after games reviewing guys for their injuries, Wednesday morning assessing their progress and Thursday afternoon a final re-check, these are all 2-3 hours a final re-check assessment to see who is healthy and who is not and their status. And then the game days is Sunday, it takes a lot of the day and if we go away whether it be London or going out to the West Coast, usually we leave the day before the game and come back the day of the game. It’s exciting, and there is literally nothing — I’m not a player obviously — but there is nothing like that game day, that feeling to be on the bus, to get on the stadium it’s a lot of fun. It’s fantastic!
Dr. Ali Kasraeian: Fantastic. What questions do you have Jay?
Jay Gray: There’s a lot of questions out there. You know I was thinking… it might not be your area of expertise, but we’re sitting here, there are NHL playoffs on, right now. I know you’re an NFL guy but why does it seem that no matter what injury an NHL guy gets he’s always back in the game, but whenever it’s the NFL you got to wait, you got to take care but in the NHL, “oh he’s a hockey player he’s coming right back in”.
Dr. Kevin Kaplan: You know it’s funny you said that, when I did my fellowship in Los Angeles, we took care of the Kings and the Ducks and it was my first game covering a Kings game and this guy got slashed, got cut open. I went to the locker room to sew him up, I’m a fellow, I’m getting lidocaine, the betadine, I’m getting everything ready to numb up the skin to put the stitches in and the hockey player grabs me and says, “What the heck are you doing, doc? Just put the stitches in, I got to get back out there.” And I just looked at him and I was like, “Is he serious right now?”. I mean he’s tough as nails–
Jay Gray: One guy basically had a heart attack on the bench, I think it was Dallas this year and then he had to be taken to the hospital and he was back within a week.
Dr. Kevin Kaplan: Yeah, I don’t know there are some injuries that broken legs, ACL tears and things like that you can’t just come back in a game. You know some injuries you can.
Dr. Ali Kasraeian: Apparently in the NHL heart attacks and lacerations are– [Laughter]
Jay Gray: That’s always the joke. “Well he’s a hockey player, he will be back by intermission”.
Dr. Ali Kasraeian: Talking about concussions, their helmets are much smaller. They’re hitting their head on ice, are the same–
Dr. Kevin Kaplan: They’re getting more aggressive, in fact our new internal medicine doctor is coming from New York and he was with the Islanders and the concussions there are getting to be more scrutinized like the NFL is now. So I think it’s all going that way. You see concussions all the time. In high school, college, pro and all different sports.
Dr. Ali Kasraeian: And do you do all various different testing? I mean there’s a whole different array of testing you have to do immediately and after and things of that nature.
Dr. Kevin Kaplan: Yes, so there’s a baseline test obviously every player takes before they come in. After they have the concussion, we do a do a test after the game to see where they are and then they go through a barrage of neuro-psychological testings in the coming days, meet with an independent neuro-logical consultant as we said and then we do a final clearance before we get them out there. So there are step-wise tests the NFL set up to say when these can and can’t come back.
Dr. Ali Kasraeian: Interesting, and before we go to a break, you were in LA during the Lakers Championship run.
Dr. Kevin Kaplan: Correct.
Dr. Ali Kasraeian: How was that?
Dr. Kevin Kaplan: Unbelievable. I flew my dad out there. It was just a cool experience just being out there in the locker room with these guys and that was the year they played Orlando and it was funny– [Dr. Ali Kasraeian: Oh wow, interesting] My dad brought out a picture, remember Otis Smith basketball camp? So I had a picture of me and Otis Smith when I was a kid so I found him in a locker room and when I said, “Hey, Mr. Smith, you don’t know me, but I know you. I met you when I was a kid” and he was like “Really?” And I showed him the picture. It was him in an Orlando Magics playing the Globetrotters back then and he was like, “Don’t show these to people.” [Laughter] Great experience.
Jay Gray: 340-1045, that’s the number to call in if you want to join in The Conversation. One segment left right here on News Talk WOKV.
Jay Gray: 340-1045, that’s the number to call. We got a few minutes left on The Conversation on News Talk WOKV.
Dr. Ali Kasraeian: So Kevin, any parting thoughts to take away? One, I think for our town, everyone in this rooms loves the Jacksonville Jaguars and they bring some wonderful things to our town. From being in there, the past couple of years, where do you see your team going? Things look positive from the vibe I get from the time I go to the stadium and talk to people about the stuff we do with them.
Dr. Kevin Kaplan: This has been an unbelievable group of people I work with now. Starting from the top, Mr. Khan, he’s obviously done everything for this team, for the city, he’s worked real hard for the city, and then you have Mr. David Caldwell, he’s our general manager who just brings in a lot of energy in terms of what he’s trying to do with the team, and coach Bradley is just an amazing coach and motivational speaker. When I heard him talk for the first time, I don’t play football, but I just grabbed a helmet and wanted to play. I mean the guy has a tremendous amount of motivation and the locker room is just full of energy with these guys. When we were having the 0 and 8 start last year you couldn’t tell from the vibe in the locker room, it felt like a 8 and 0 team that’s how good it felt to go to work and go to work for these guys.
Dr. Ali Kasraeian: In London it felt like we won the Super Bowl. I don’t know what they did over there but it was an amazing vibe.
Dr. Kevin Kaplan: In London, it was awesome being around the team the whole time, everybody is excited to be there and even though the game got out of hand towards the end, you couldn’t tell by the players. Not at all. These guys were great and they just have a good energy about them. It’s all about playing to the potential. They’re not focusing on the wins and the losses, they’re focusing on playing the potential and when you go to work especially for what we do from the medical side that are just amendable to learn and are listening to what we want to say about the team, about the players and so it just makes the environment so unbelievable and enjoyable to go. So I think our team is just looking up and up and every year it’s going to be better.
Dr. Ali Kasraeian: So hopefully everyone will get out there and support them this year. What do you think Jay? In terms of the players.
Jay Gray: It’s good. I think it’s going to be a great year this year. I mean early picks this year it is going to be… it’s going to be a lot of fun.
Dr. Kevin Kaplan: Got 11 draft picks. A lot of picks in the drafts this year.
Jay Gray: I wouldn’t be surprised if they got the first round pick traded a couple of those, and maybe move back into the first round. Get a quarterback in the late first round. I wouldn’t be surprised at all.
Dr. Ali Kasraeian: Now Jay and I were talking about this before you mentioned it earlier. I’m trying to go out for a 4th string punter and he’s going to be my 4th string–
Jay Gray: When you got a punter drafted in the third round, there’s not going to be a back-up plan.
Dr. Ali Kasraeian: They’re going to need someone. If they’re weren’t going to get injured they wouldn’t be checked in–
Jay Gray: If I were you I would call up the Sharks. You might have a better chance with them.
Dr. Kevin Kaplan: Hey I take care of the Sharks too and those guys are pretty good too.
Dr. Ali Kasraeian: If you get me a tryout I’d embarrass myself well but it would be a fantastic job to sit in the sideline and never punt and make a good living doing–
Jay Gray: You know what we’ll do? We’ll put it on WOKV.com, we’ll get that video up there.
Dr. Kevin Kaplan: That would be awesome. I would pay to see that. I would check his knee out first.
Dr. Ali Kasraeian: And they would play this song everytime I went out to the field to punt.
Jay Gray: Guys, thanks for joining us this week on The Conversation. We’ll be back again next week. We have an update from FOX News coming up, plus a look at your Easter forecast looking a little nice now and I think it’s going to brighten up in spite of all the rain we had earlier today. It’s going to look all nice for your Easter Sunday. Thanks for joining us here on AM 690 and 104.5 FM News Talk WOKV.[End of Audio]