Podiatry In Professional Sports

Podiatrists may play a multitude of roles when working with professional athletes. This can include, but is not limited to: pre-game preparation; strapping; taping; lower extremity physical medicine; during-game care; injury triage and treatment; and post-game recovery. They also provide expert care and evaluation outside the sports venues on a non-urgent basis. The panelists interviewed for this article all found integral ways to apply their expertise to the athletes and teams they serve.

Chanelle Carter, DPM, FASPS shares her 15 years of experience as a team podiatrist and consultant for the DC Divas Women’s full contact football team. Among her duties in this role, she attended practices, games and training in order to assess, diagnose and treat various acute and chronic injuries, deformities or conditions affecting the athletes’ performance. She performed surgery as needed and advocated for injury prevention.

“I am no longer active on the field, but the team continues to refer players and staff to my office,” she says. “I also provide additional consultations as necessary.”

Jessica Merker-Levy, DPM, DABMSP, has nine years of experience as a team podiatrist for the New York Red Bulls (MLS) and served for three years as a consultant for the New Jersey Devils (NHL). She explains that in her current role she goes to the training room a few times a month for about an hour-and-a-half prior to practice, working closely with training staff and orthopedists.

“Players come to see me for a variety of routine issues, such as ingrown toenails, calluses, subungual hematoma, tinea pedis and mycotic nails,” she says. “I treat them conservatively in the training room, however, if there is an issue on a day I am not there, or they need an in-office procedure such as an ingrown toenail removal, the trainer will call me directly and send the player over to my office for evaluation and treatment.”

Biomechanical evaluations and treatment plans are also an integral part of her work with the Red Bulls, including after acute or chronic injuries, fractures, stress fractures or surgery.

“I will often speak to the orthopedist who performed the surgery and discuss how a custom-molded orthotic can help speed up recovery time, return-to-play and prevent re-injury,” she explains.

Jennifer Gerres, DPM, FACFAS is a consultant podiatrist for the Washington Mystics (WNBA). In her case, she points out that her responsibilities are not limited to the sports season, as she performs lower extremity physicals and casts for orthotics before the season even starts. She points out that there is often only a very short time between when athletes may return from playing overseas and arriving at training camp.

Howard Osterman DPM, FAAPSM, DABFAS has 25 years of experience spanning roles as a team podiatrist for the Washington Wizards (NBA) and a consultant for the Washington Mystics (WNBA) and DC United (MLS). He is also a past team podiatrist for the Washington Nationals (MLB). He points out that exact duties of a podiatrist in these settings can vary depending on which professionals make up that organization’s medical team. Members of that team, he says, can include a head team trainer, a head physician (often an orthopedic surgeon), a primary care physician and multiple support staff. In his experience, team podiatrists are often consultants rather than salaried physicians, with compensation possibly per diem for game attendance or based on services rendered.

“Ultimately, in my experience, the job duties will vary depending on the expertise and whim of the trainer and orthopedist,” Dr. Osterman details. “Over the years, my main duties have included evaluation of foot and ankle injuries, palliative care for nails, calluses, warts and obviously, orthotics.”

Lisa Schoene, DPM, ATC, FACFAS has spent over 30 years working with professional athletes as both an athletic trainer and a podiatrist. Her work includes consulting for the Joffrey Ballet, Hubbard Street Dance, Ballet Chicago, Inside Chicago Dance, Elements Contemporary Ballet, Chicago Tap Theatre, and many others. She covered men’s speed skating and men’s wrestling at the 1996 Atlanta Olympic games, has provided services for World Cup soccer, and multiple other sports at the elite level. She shares that her experience treating these players also includes working with athletic trainers and coaches, performing pre-season screenings and giving presentations for the trainers or athletes on various topics.

“Because of my athletic training background, I always incorporate all my hands-on, emergency field experience and combine it with my podiatry knowledge to treat every athlete with a very holistic, biomechanically-driven approach,” says Dr. Schoene.

She stresses that she focuses on evaluating the full body of the athlete, looking at at strength, flexibility, biomechanics, and posture. Evaluating the whole chain including the lower back, hips and knees, is important, she adds, as is inquiring about their nutrition status and needs.

“Analyzing shoe gear and utilizing physical medicine treatments and orthotic devices are also important and a large part of what I do daily,” she shares. “I personally give treatments, exercises and devise plans for return to play or dance for my athletes.”

Howard F. Liebeskind, DPM, FFPM RCPS (Glasg), DABMSP, FAAPSM is currently the team podiatrist to the Los Angeles Lakers (NBA), Los Angeles Galaxy (MLS), US Men’s and Women’s National soccer teams, Los Angeles Football Club (MLS) and Pepperdine University. During his 42-year career, Dr. Liebeskind has held many prior consulting and team affiliations in the US and abroad.

As part of his duties, he relates coordinating the podiatric segments of pre-participation screenings, examinations and evaluations, along with managing injuries on the field of play at the direction of the head athletic trainer and team physician. In addition to medically managing podiatric injuries and illnesses, he says he coordinates proper and safe return-to-play plans with the training and physician rehabilitation staffs.

“Podiatrists in these positions integrate their medical expertise in coordination with other health care providers and members of the sports medicine staff,” says Dr. Liebeskind. “It is important to have a knowledge of trauma, musculoskeletal injuries and medical conditions in athletes, along with fundamental knowledge of emergency care in the context of sports events.”

What Aspects Did These Podiatrists Find Most Rewarding?

Whether with other health professionals, team staff, or with the athletes themselves, the podiatrists I spoke with feel that building relationships is one of the most interesting and rewarding parts of being part of a professional sports organization.

“It has been incredible to get to know these national and international athletes and hear their personal stories of their soccer journey around the world,” says Dr. Merker-Levy.

The panelists at that there is also a sense of accomplishment in being a part of the bigger organization, supporting these athletes in achieving their goals.

“It is gratifying to be a part of and witness the athletes thriving and succeeding in their sport,” says Dr. Carter.

Dr. Gerres agrees, recalling her experience when treating and working with the 2019 WNBA Championship team.

“The Mystics are an exceptional group of women and I was proud to watch them win and celebrate with them,” she says.

How one integrates their role as a podiatrist into these organizations’ medical teams is a very interesting aspect, according to Dr. Osterman. He feels there is much to learn working with physical medicine and rehabilitation positions, nutritionists, acupuncturists, massage therapists, athletic trainers and orthopedists, among other potential professionals.

“It is truly a part of the medical world where podiatry can be an equal partner,” he adds. “The collaborative effort in getting an athlete ready to participate at an elite level is often a challenge. Making sure that the athletes understand that you are working on their behalf is extremely important.”

Dr. Schoene agrees and adds that humility and respect towards all parties leads to a genuinely rewarding experience.

“Having the opportunity to treat these dancers and athletes is a gift and should always be deemed as such,” she relates. “Walking into a training room is like home to me. I love the feeling of the camaraderie between the athletes, athletic trainers, and myself. For my professional dance experience, that opportunity is especially cherished, as working with a dance company’s inner circle is not always easy and is generally protected from outsiders.”

Overcoming Obstacles And Challenges

In the context of elite athletes with high expectations and goals, there are bound to be challenges for any provider helping them on that pathway. Time, both that of the podiatrist and the athlete, is of the essence, according to several of the panelists. Dr. Merker-Levy, currently in practice in Short Hills and Morristown, NJ, cites timing and coordination of minor procedures as an important balancing act.

“If a player needs a procedure for an ingrown toenail or a wart, we try to schedule this so as not to interfere with training and games,” she explains. “There is not always as much time as you’d like to provide for rest.”

She goes on to say that the players’ travel schedules and game frequency allows distinct, but limited windows of time to accomplish these needs.

“Sometimes we just provide routine care to keep players comfortable and in the game, and perform more permanent procedures such as a phenol and alcohol procedure, in the off-season,” she adds.

Dr. Gerres, who practices in Silver Spring, Maryland and Washington, DC agrees that the time commitment and travel schedules of these athletes are complex points. Many of the athletes she works with do not have an off-season, often flying overseas to play only days to weeks after the WNBA season ends. Conversely, there isn’t a large break before beginning their next season in the US, and sometimes they return injured.

“These times can be hectic and require flexibility,” she says. “I look at it as if I’m on call. For example, if there is an injury on a west coast trip, I might get a text or phone call after midnight.”

Dr. Osterman, who practices with Dr. Gerres, points out the existence of potential conflicts of interest between working for the team and interacting with the player, family, and agent as challenges. Also, in his experience, not all foot and ankle injuries necessarily receive podiatric treatment.

“We like to think we are the experts, and often we are, but there are times that it is appropriate to send a player to an outside medical team,” he explains. “Putting ego aside can often be a difficult aspect of this, but understanding your role within the medical team is paramount.”

Practicing in Chicago and Gurnee, IL, Dr. Schoene details on obstacle in that her treatment plans for such athletes may not be the same in her office versus a training room or studio. Protocols can vary and some treatment regimens may not always be available in all settings. However, she relates that flexibility and adaptability, along with multiple treatment options to choose from helps her overcome that obstacle.

Dr. Liebeskind, who practices in West Hills, CA, recalls a particularly challenging moment during an era when international airline carriers did not have a requirement to fully train flight attendants in cardiopulmonary resuscitation and when support technologies, such as AEDs, were not commonly available.

“I was left to my own skill set, abilities and training to revive a senior member of a team’s administrative staff following a cardiac event while in flight. It’s not a question of if such an event might happen to you during your sports medicine career but rather when it will happen.”

To this end, Dr. Liebeskind recommends podiatrists participate in the team’s Emergency Action Plan (EAP). Clearly understanding this plan and its protocols allows one to react properly in a multitude of emergency situations, he explains.

Circling back to the athletes themselves, and especially because many of those involved have a genuine love for the sports they serve, Dr. Carter, in practice near Baltimore, finds witnessing career-ending injuries and other traumas that may inhibit athletes from resuming optimal performance as especially difficult.

How Did These Podiatrists Get Started?

Hard work, a love of the sport, willingness to volunteer in some regard and networking are all important points that our panelists cite as contributing to them finding their current roles as podiatrists involved in professional sports. While still in residency, Dr. Carter took the initiative to contact her team’s medical doctor and conveyed her interest in volunteering, which led her down her current path. Dr. Schoene agrees that volunteering can go a long way into obtaining such a position.

“It really takes some time to join a team or get into a professional situation,” she says. “Some of the best things I have accomplished in my vast sports medicine experiences have been unpaid, but have paid me back handsomely over and over again in many other ways.”

Dr. Liebeskind pointed out a running shoe design flaw in an ad in an athletic-oriented publication in the 1980s, and this began his trajectory. He participated in a medical advisory board for that publication, which then led to working with, and gaining a positive reputation among, professional teams. This hard work and dedication eventually resulted in long-term relationships with multiple teams, including an invitation to be a team podiatrist to the US Men’s National Soccer Team at the 1994 FIFA World Cup competition.

Dr. Merker-Levy got to know the realm of providing care for professional athletes through practicing with her husband, who is a chiropractor. When a team position for a podiatrist became available, she was already acquainted with the head trainer. However, she points out that the underwent a rigorous interview and pre-position process, spending time with the trainers, doctors and players before being offered the role.

Paul Taylor, DPM, a Past President of the American Academy of Podiatric Sports Medicine, was a predecessor for both Dr. Osterman and Dr. Gerres in their position as podiatrists treating professional athletes. Dr. Taylor was the team podiatrist for the Washington Wizards in the early 1990s, and Dr. Osterman began sharing duties with him shortly after joining his practice. In the late 90s, Dr. Osterman added the Washington Mystics to his roster. Dr. Gerres joined Dr. Osterman in caring for the Mystics when she came on board in the practice, which fulfilled a significant goal of hers professionally.

“I jumped at the chance, as it has always been a goal of mine to work with a professional sports team,” she says. “I was very lucky to find a practice like mine that specializes in sports medicine and providing care to elite athletes. I knew that I wanted to be involved with professional sports for a very long time. My aunt, Francine Gerres Lubera, was part of the Baltimore Ravens front office, and I had unique exposure to the lifestyle and a great role model.”

Dr. Schoene agrees that volunteering can go a long way into obtaining such a position.

“It really takes some time to join a team or get into a professional situation,” she says. “Some of the best things I have accomplished in my vast sports medicine experiences have been unpaid, but have paid me back handsomely over and over again in many other ways.”

Pertinent Suggestions For Interested Podiatrists

Many of the DPMs interviewed cite starting at the local and youth and club levels as great entry points to involvement in professional sports. Attendance at practices and games allows one to introduce themselves to coaches, trainers, physical therapists and other key individuals. Sharing the training and education of a podiatrist and how podiatric services can benefit players’ performance and health is also a strong recommendation from some of the panelists. Networking and getting to know other physicians to who treat athletes in your area can be another fruitful pursuit. Lectures or foot screenings for clubs or teams are other options mentioned.

Specifically, Dr. Liebeskind, a founding member of the ABPM CAQ in Podiatric Sports Medicine and the ABPM CAQ in Podiatric Sports Medicine exam committee Ex officio Sub-Chair, recommends credentialing via available pathways in the podiatric profession. Collaboration between the American Academy of Podiatric Sports Medicine and the American Board of Podiatric Medicine has created a structured, clear path for interested DPMs to demonstrate their skills and expertise, he says.

“By achieving specialty board certification, Fellowship status in the AAPSM and obtaining a CAQ in Podiatric Sports Medicine from the American Board of Podiatric Medicine, the arduous path I followed is fortunately a thing of the past,” he adds. “The above pathway provides certification and validation of the sports podiatrist’s expertise, and with five years of clinical sports medicine experience completed, many professional teams and leagues will welcome qualified individuals to become members of their multidisciplinary sports medicine programs.”

How The Health Care Team Supports The Sports Team

According to these DPMs, communication with other members of the care team for these athletes takes place often and in multiple forms. Phone calls, texts, emails, formal letters and important documents such as injury and recovery lists can all be communication tools. Each team may have a unique first contact, but often, they share, this is the head trainer.

“Treating professional athletes is a multidisciplinary team approach and direct communication with everyone is key,” says Dr. Merker-Levy.

Part of this communication can involve making it clear that you will accommodate same-day appointments in your office for the players when necessary, adds Dr. Schoene. Dr. Osterman points out that in order to effectively communicate with the care team members, he feels it is important to be up-to-date on technologies and treatment protocols so that, even when there is a difference of opinion, the provider is able to speak clearly and intelligently about the case at hand.

The pre-game meeting is a unique setting in which Dr. Liebeskind feels important communication with other specialties and care team members takes place. This may include discussing the current status and availability for play of every athlete to contribute to coaching decisions.

Dr. Gerres shares that the communication positively extends outside of the training room.

“Our medical team is a great group. If it’s at the game, we’re talking or sitting with each other,” she explains. “We meet before and after games with the athletic trainers and coaches. If it is outside the games, we’re calling and texting. Days, nights, and weekends.”

Final Thoughts

Dr. Carter finds significant gratification working with the professional sports community, inspired by assisting with the health and wellness of the athletes.

“I have a continual referral base including the staff, athletes and their families,” she adds. “Over the years, I have developed a great rapport with the organization and it has afforded me a unique opportunity to educate the community about our wonderful profession.”

Working with two professional teams, Dr. Merker-Levy found her role to primarily be in conservative care, which she notes athletes express great appreciation for.

“Conservative care is so incredibly important to them and I appreciate being part of the medical and training staff that keeps the athletes playing and at their best,” she says. “As podiatrists, we understand biomechanics, custom orthotics and shoe gear better than any other profession. Our knowledge is respected, appreciated and well-integrated into the overall health of the athletes.”

Dr. Gerres echoes experiencing that same gratitude from the athletes, and goes on to say that through their efforts and expertise, podiatrists can educate other members of the health care team regarding a DPM’s skills while building important camaraderie.

Having the benefit of 30 years in the field, Dr. Osterman has witnessed significant changes in how professional sports teams utilize and find their health care providers. In his experience, there is influence from large hospital systems and noted experts, making it more difficult to enter into the field solo.

“Mentoring with people who have attained some level of notoriety in the field is extremely beneficial,” he says. “Those relationships carry a lot of weight. I think an active participation in the American Academy of Podiatric Sports Medicine, especially becoming a Fellow, is a necessary part of the education process.”

Citing the foundational importance of the foot, Dr. Schoene feels there is an extremely important place for podiatrists with professional sports or other elite club sports.

“The foot is the foundation of the body and generally the most important part, as without proper function that foot will not be attached to a professional athlete or dancer!” she says. “If improperly aligned, weak, imbalanced, or not functioning properly for any other reason, that athlete is basically out of luck. Podiatrists can and should be an integral part of every care team.” 

Dr. Spector is a Fellow of the American College of Foot and Ankle Surgeons and the Immediate Past President of the American Association for Women Podiatrists. She is the Managing Editor of Podiatry Today.