As the Falcons’ head team physician, Dr. Spero Karas oversees orthopedic and medical care for every Falcons player. He’s at every game on watch from the 30-yard line. During games, he’s not a fan, but instead a clinical observer.
Karas is also an associate professor of orthopedics at Emory University. Karas will head to Houston Wednesday morning. The Atlanta Journal-Constitution recently interviewed Karas about his role with the Falcons, preparations for the game and enthusiasm about the Falcons facing the New England Patriots in the Super Bowl at 6:30 p.m. Sunday, Feb. 5. (The interview was edited for length.)
Q: What is it like to be on the sidelines of a game?
A: It is fairly systematic. It is myself as the head team physician and a series of additional doctors. There is going to be myself as an orthopedic surgeon and typically a second orthopedic surgeon and then two medical physicians, one of which is in charge of our concussion program and does a lot of our hydration therapies. You’ve also got the league-mandated unaffiliated neuro consultant, and in our case it is a neurosurgeon, and there is also an emergency airway doctor on the sideline. He wears the red shirt and the red hat and sticks out kind of like a lit-up Christmas tree, and he is very conspicuous and he is always at the 30-yard line at all times so everyone knows exactly where to find him if there are airway issues of any type. The other team has this as well. So lots of doctors. We (physicians) tend to stay out of the coaching box. We tend to stay on the 30-yard lines and we observe the game. We are essentially there for observing the games for injury. Our job is to implement standard medical care. In addition to us observing the game, the NFL has mandated a spotter in the booth so that spotter has this kind of 360-degree global (and can review video). There are lots of layers of protection.
Q: There is so much going on during the game. The roar of the crowds. The big plays. How much of that do you pay attention to?
A: As a physician, you are not a fan, and you are not a coach. You are a physician. Just like if I had a patient in the office and I was observing: Let’s say they were having difficulty raising his or her arm up in the air, my role is to observe that. When I am observing the game, I am observing the players and my primary focus is not the score. I am an academic surgeon and I have the opportunity to teach young doctors, and my mantra is stay detached, stay clinical, and stay in the moment.
Q: What are the keys to injury prevention?
A: A typical pregame could require a hydration regimen, which could be oral fluids or even IV fluids before the game, and we tend to leave that to the discretion of the player how much he feels he needs in the tank per se before the game. There is a prep room where they are doing stretching, very light weights, bands, rollers, rolling their muscles, and these are all things, proper hydration, good stretching, good rolling and good prep, that could be extrapolated for the layman population. … Before the game, there is lot of massage, taping, all of these different things. Before a Falcons game, typically you arrive three hours early before, so for a 1 p.m. kickoff, you arrive at 10 a.m. You’ll see the players go out on the field at 12:20 for warmup. … But really that is the very end of the preparation, which started the previous two hours.
Q: With the Falcons going the distance to the Super Bowl and playing a long season, how has that changed the approach to injury prevention?
A: In my role, I just continue to do what I have been doing, monitoring the players, monitoring their progress. It is pretty easy to keep it clinical. On the performance side, I can’t speak in great detail about what the coaches are doing, but certainly, there is the management of the output and repetitions and stress the players are putting on their body. … For a layperson reading this article, the priorities are always nutrition, recovery and sleep. We don’t do it any differently in the NFL. We make sure the guys are sleeping. We make sure our guys are getting good recovery therapies with hydration, icing, stretching after exertion, and certainly maximizing nutrition.
Q: The league released data that show overall concussions for the preseason and regular season were down from 275 in 2015 to 244 in 2016 and emphasized that players are doing more self-reporting of head injuries. Is this decrease in concussions significant?
A: If you look at the number of concussions over the last five years, the numbers to tend to hover 10 percent, up or down. The number was 10 percent down from last year, but the number may have been 10 percent up last year from the previous year. What’s particularly encouraging is a consistent drop in concussions suffered during regular seasons during the past five years. Certainly there have been rule changes in the NFL and awareness in tackling that may actually be contributing to a lower number, so we are cautiously optimistic that with safety measures that have been introduced in the NFL in terms of some of the special teams plays and tackling awareness that number will continue to come down, not just a 10 percent blip this year, but the number will continue to come down the years to come.
Q: During the game, you can’t be a Falcons fan, but otherwise, do you consider yourself a fan?
A: I have lived in Atlanta 12 years now, and I tend to pull for the hometown teams. My family and I consider Atlanta home. We love all of the hometown teams. We love the Braves. We love the Hawks. We love the Falcons. We love the Atlanta Dream. We are fans when we are not working. Unfortunately or fortunately for me, I am always working when the Falcons are on the field.
Q: What do you think about the Falcons going to the Super Bowl?
A: It is an extraordinary story, and having some insights of the inner workings of the team, it couldn’t happen to a better group of guys. It is just an extraordinary group of young men who have really put in the time, and a group of really caring, intelligent, tireless coaches who have put literally thousands of hours of plying their trade and perfecting it, and it is so nice even from an outside observer standpoint to see these long hours and hard work be rewarded with a trip to the Super Bowl.