I have experienced medical imaging from a perspective that is a bit out of the ordinary, spending my Sundays working on NFL sidelines. The fast-paced, physical world of professional football has taught me a great deal over the years, and I like knowing that I am making a difference in the lives of these athletes.
On any given Sunday at any NFL game, there are at least 27 medical personnel standing ready. They are divided into three teams: the home medical team, the stadium medical team and the visiting medical team. The radiologic technologist is a member of the stadium medical team, and it is a role I have been serving for the last 15 years for the Seattle Seahawks. (I am also an imaging consultant for the Atlanta Falcons.) The radiologic technologist is responsible for both teams before, during and after the game. I started with the Seahawks in the team’s operating room, but was then asked to become radiologic technologist after I had built strong relationships with various physicians.
As the NFL has placed more emphasis on chronic traumatic encephalopathy (CTE) over the last several years, I’ve watched the radiologic technologist’s role grow in importance in terms of assisting with both diagnosis and treatment. When I started with Seattle, for example, we had a very small X-ray room and a darkroom for processing films. Now, we have a state-of-the-art trauma radiographic room with digital images we can send directly to the sidelines as needed. We have fluoroscopic imaging within the stadium as well.
Imaging professionals in the NFL also have evolved in terms of our protocols and the images we obtain. In the past, we would assume game-day injuries were going to be orthopedic, and most still are. But due to greater CTE emphasis and awareness, we are trained to look for the signs of injuries of the brain during our imaging process with a player. When we have players in our X-ray room to treat a specific orthopedic injury, we still watch closely for the effects of CTE during that initial imaging process. Being aware of the subtle signs associated with concussions and other similar head injuries is a significant part of the radiologic technologist’s job.
I’ve watched imaging protocols evolve during my time with the NFL. In the past, we would image C-spine injuries with just AP, lateral or the occasional flexion and extension. Now, if a player has a cervical injury, we automatically perform AP and lateral skull images as a baseline along with the normal cervical images. Players are usually scheduled for an MRI after the game. Each team has its own protocol, which is established by team physicians and staff.
Scouting Head Injuries
A lot of time and effort is put into watching for potential player issues related to CTE. At every NFL game, there are two unaffiliated neuro trauma consultants, one on each team sideline. There is also a “spotter” in the press box that looks for signs of concussion-type injuries during the game and communicates the information to the neuro specialist on the sidelines if they suspect a player has a concussion
type of injury. When a player has an injury and the neuro trauma specialist gets involved on the sidelines, this is sign to us that this player may have a brain injury. When we take that particular player back to be checked out, we watch for signs that he could have a brain injury during the orthopedic imaging process.
During games, we have tricks that help us keep a close eye on players. We try to get to know the personality and demeanor of most of the players as this helps us notice if the player’s personality is abnormal during the imaging process. A few years ago, we had an incident with a player that trainers thought had a shoulder injury. Once they brought him to X-ray and we were in the process of acquiring the shoulder images, we noticed a personality change from the norm and indicated that to the team physician. The player was later diagnosed with a concussion.
We also are on the lookout for “positional injuries,” which are more common with athletes who play certain positions. Quarterbacks, for instance, are prone to shoulder and clavicle injuries. Defensive and offensive linemen more often have knee and ankle injuries, and receivers are prone to wrist and finger injuries. These positional injuries are associated with a repetitive situation and paying attention to these helps us have a better understanding of what each player is going through at all times.
The Language of the Game
The NFL game comes with its own patterns, language and terminology. Understanding and embracing these terms helps us know how to do our job when the time comes. If a player tells us he got “chopped,” “cut” or “rolled up on,” we know the area to image and the common injuries associated with those terms. This terminology is common among the medical and training staff and passed down to us; it’s all part of learning about the game.
One of the biggest challenges of working in the NFL is imaging these especially large athletes. The players are much larger than average patients, and we often need to deal with their bulky gear. I will find myself asking the question, “Should we take it off or do we try try to image through it?” Of course, I’ve been trained on how to remove the gear quickly and without causing more harm to the player.
I’ve experienced a lot during my time taking care of NFL athletes. I think the league does a great job of caring for its athletes and considering both their short-term and their long-term health. I’m proud to say that the radiologic technologist plays a big role in this care.
Anthony Anderson, RT(R), is a radiologic technologist for the Seattle Seahawks and an imaging consultant for the Atlanta Falcons.