Gameday starts for David Diduch, the head orthopedic team physician for UVA Football, while you’re still tailgating in the parking lot.
The medical and training staff is on-site two hours before kickoff.
“We try to get there about 15 minutes before the team arrives, because that’s a bit of an ordeal with the buses pulling into that garage and letting the players off and where you park and so forth,” said Diduch, who is in his 23rd season of working with UVA Football, succeeding the legendary Frank McCue as the head orthopedic team physician.
Diduch, also a professor at the UVA School of Medicine, took us behind the scenes of a UVA Football gameday from the medical and training perspective on a recent episode of “The Jerry Ratcliffe Show.”
One thing to know ahead of time: sometimes when the medical tent goes up on the sidelines, it’s not because of injury.
Yep. Nature calls.
Another thing that you wouldn’t automatically think of, but makes sense once you know it: these folks are on call for every practice, every scrimmage, and they might be their busiest the day after a game.
“Sunday afternoon, starting at noon at the McCue Center, we have an injury clinic for players injured the night before. It’s remarkable to me things will bubble up the next day that player didn’t even complain about the night before, and they’ll be significant, and just, you know, then the soreness settles in,” Diduch said.
The busy season starts with the beginning of training camp.
“It’s 100 athletes in a contact sport, and they’re going at it every day. Starting right at the beginning of August, we get very busy,” Diduch said. “We come over in the evenings after we finish in the operating room or in the clinic and check on athletes, and there’s always a half dozen or so that just needs something checked out, who needs an X-ray, who needs an MRI, and that goes through August, and that’s going to include covering the scrimmages. Pretty much my weekends are spoken for for the entire fall from beginning of August all the way into December.”
This, of course, includes road trips, which means travel the day before, and weekdays are also busy, juggling the normal workload with medical practices along with football.
“During the week, the players are going to come to our clinic, and we have designated appointments set for them. We’ll start actually at 7:30 in the morning, and we have slots available for that for the athletes for all the sports, and we also make this available to area high school athletes,” Diduch said.
“They’ll get x rays and get triage and taken care of, and then we’re just always, you know, monitoring for when these test results come back in real time,” Diduch said. “We’re giving them the results of the MRI in real time within minutes, so when they come out of the MRI scanner, we’re looking at the MRIs, communicating with athletic trainers, getting a treatment plan, deciding what’s next.”
Gameday begins with trainers taping ankles and helping players with their shoulder and knee pads, braces and the rest, and both the training and medical staffs watching warmups.
On the field, the trainers are the first out if a player goes down with an apparent injury issue, signaling to the sideline if a doctor is needed, with specific signals on who is needed – whether it’s an orthopedic issue or a concussion issue.
“Probably the most critical decision we have to make is, first of all, is it safe for a kid to go?” Diduch said. “Is this just something that hurts, and they can go if they can? Or is it not safe? And if we need an X-ray, we can get it. We’ve got an X-ray machine there at the stadium, and we have an X ray tech ready to go on call. And by the time we’ve got an athlete back to where the X-ray is, the tech is there and ready.”
The setup at Scott Stadium for X-rays is top of the line. Results are practically immediate.
“As soon as we roll an athlete into the X-ray room, which is kind of in between where the two locker rooms are there at Scott Stadium, the tech is ready, they’ve got the machine fired up and the athletes positioned, they shoot an X-ray, and it’s all digital now,” Diduch said. “From there, it goes into a processor, and you see it come up on their screen in less than 30 seconds, and we’re looking at the X-ray results on the machine screen, and then eventually that gets transferred to the computer and then to the whole record system.”
The UVA staff works with staff from opponents when one of their players is injured.
“It’s actually a very friendly effort,” Diduch said. “We’ll meet with them before the game, make sure they know where all the facilities are, where X-ray is, what our resources are, where the hospital is. And so we’ll work together. I mean, the more serious the injury, both medical staffs will definitely work together. Many times, we’ve worked together for like a difficult, difficult shoulder dislocation, head injury, spine injury.
“We’ll send somebody to the hospital if it’s a suspected spine injury to go with the athlete in the ambulance, even if it’s the opposing team, we’ll do that. And then we’ll have one of our staff there in the emergency room helping with their staff all the way through from the time the patient hits the door to the necessary X-rays, MRIs there with the athlete, one of the training, staff plus one of the doctors. And if they need to be admitted, which occasionally happens, we’re there with them, too. So, it’s a very collaborative relationship for medical care of these kids,” Diduch said.
The example of spine injuries brings up something that the medical and training staffs practice in the summer.
“You don’t want to leave that to figure out, you know, in the moment, so we get together every year, as the season begins in August, and we practice with our staff that’s going to be covering the games plus the rescue squads, the EMS staff, the actual guys who will be at the at the stadium, and we go through the whole drill and what’s different scenarios,” Diduch said. “What if the player is lying facedown? What if they’re on their back? What if they’re unconscious? And go through the whole thing. How do you get the person onto the backboard? We practice removing the equipment, the whole bit, and we go through it several times, so that we’re not figuring it out in the moment.
“I’ve been involved with several situations where I’ve had to find board athletes for our team and other teams. I think it’s a credit to the staff and the preparation that it has always gone really, really well. Knock on wood, we haven’t had anything too serious and in quite some time. That’s a very fragile thing too. It really is the case where precision matters, there’s no question about it. Everybody has to be on the same page,” Diduch said.
Back to gameday: halftime is a “fire drill,” Diduch said, with the medical and training staffs hoofing it into the locker room ahead of the team.
“We’ll see players as quick as we can right away when we get in the locker room, because we want to take care of whatever we need to take care of retaping ankles, things like that, provide some Advil or Tylenol, whatever,” Diduch said. “Occasionally, sometimes things need to get injected that are just a matter of soreness. But always, once we know it’s safe, get an X-ray, we’re often getting X-rays on one or two players, and we get that done as quick as we can, because the coaches need time with the kids.
“There’s usually the first few minutes into the locker room or time for the guys just to grab something to drink, there’s snacks available. And during that time, we’re trying to take care of the medical needs, so that then these players can get back in with their position coaches,” Diduch said.
The staffs are on hand for at least an hour after the game, “basically evaluating players, deciding who needs to come in the next day to the injury clinic,” Diduch said.
“So, it’s a long day, as you know, with the game being about three and a half, four hours long, two hours before, an hour after. It’s pretty much a full day,” Diduch said.
Story by Chris Graham
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Chris Graham
