Take Cincinnati Bengals quarterback Joe Burrow, for example, who was sidelined after he was tackled by a Jacksonville Jaguars defensive lineman in Week 2.
The video of how he got hurt wasn’t immediately clear, leading Morse to ponder a multitude of questions: “Was he walking [after getting hurt]? Was he in a scooter? Which foot was it? How did it happen? Was it a contact? Was it noncontact? Does he have an injury history of this specific injury or this area of the body? Then from there, you narrow it down to the different injuries you can have for that area.”
Initially, Morse wrote that it was a “left toe injury” that was a “turf toe vs. toe fracture vs. toe dislocation.” It ended up being the former. Morse then said he was “expecting Joe Burrow to miss at the minimum four weeks but [the injury could be] potentially season-ending.” After Burrow had surgery, Morse wrote that “there’s a small chance he’s able to return in December.”
Burrow got back on the field against the Baltimore Ravens on Nov. 27.
While fans crave instant information, the doctors say they aim to not rush out a diagnosis.
“You don’t want to just get out there as fast as possible and be wrong,” Christ said. “You want to be known for being accurate. So I would personally rather take my time and really evaluate the video and then put out my thoughts.’”
Dr. Nithin Natwa, a board-certified sports physician who now works at an urgent care facility in Chicago, said specific language is key. It’s best for professionals to never say a player has an exact injury or will be out a certain amount of time because they are ultimately giving their best guesses.
“It’s really important to be measured in the language that you use and just kind of say, ‘These are possible outcomes, and it seems like it’s more likely it’s this one, but without having imaging results or physical exam, it could definitely be one of these less severe cases.’ I try to give all the options out there.”
Though they work to be as precise as possible, some other medical professionals say they aren’t sure that the standard has been met.
Stephania Bell is considered a pioneer in the field. Bell, ESPN’s senior writer and injury analyst, joined ESPN in the fall of 2007 after more than 17 years as a physical therapist and orthopedic clinical specialist. At that time, very few (if any) medical professionals wrote or spoke on television about sports injuries.
She initially found inspiration from members of her fantasy league.
“The guys I played fantasy football with knew (I treated athletes) and were asking me questions all the time, and that’s how I started to realize that the information was probably marketable,” she said. “And I saw that fantasy football was growing.”
Today, she is considered one of the most trusted injury experts in sports media, co-hosting the popular “Fantasy Focus Football” podcast and making regular television appearances. The one place you won’t find her, however, is on social media giving instant prognostications about injuries.
Because she doesn’t have access to any imaging and isn’t examining a player in person, she prefers to wait until a team releases an official update or one of ESPN’s many “insiders” provides the latest.
Being right matters more to her than being first.
“The medical folks who are actually covering the teams don’t love it that people are ripping off these diagnoses,” she said. “They’re frustrated because they’re like, ‘I can tell you how much more goes into it with being there, and we still don’t always know.’ So I understand there’s an appetite for quick information, but for me, in my professional lifetime, that’s just not where I’m gonna live.”
Dr. Christopher Cooke took it a step further. Cooke, an orthopedic surgeon outside Detroit who was a team doctor with the Tigers and a consultant for the Red Wings, said fans must be skeptical about what they see online.
“There’s a lot of armchair doctor people out there who make comments,” he said. “Not to sound too boisterous, I don’t think the majority of them really know what’s going on.”
Cooke was in a five-year orthopedic surgery residency followed by a one-year sports medicine fellowship at Kerlan Jobe Medical Center in Los Angeles. It was there that ulnar collateral ligament reconstruction — or Tommy John surgery — was first conducted.
Cooke said experience is needed to be able to properly diagnose an injury. Otherwise, medical professionals are “at a disadvantage.”
“They don’t have the five years of studying the body. They don’t have the hands-on experience. They’ve never held an ACL in their hand as they reconstructed it. It’s someone who certainly could fit a role, but they’re not an expert in the area.”
“There’s only a finite amount of people I really trust what they say,” he said later. “And oftentimes these people online don’t have the training to make the right comments, but they have enough knowledge to just spout out something. Oftentimes, in my opinion, they’re very, very wrong.”
Though most take extra caution when they make diagnoses, specifically saying a certain injury or timetable is “possible” or “likely,” there are times when the medical professionals miss the mark.
After Arizona Cardinals running back Trey Benson injured a knee on Sept. 25, Natwa went on Instagram and said he should return in five to seven weeks. Instead, two months later, the team announced he wouldn’t be back at all this season.
Dr. Tarek Souryal is an orthopedic surgeon who was a longtime team doctor for the Dallas Mavericks. While he agreed with Cooke that some online doctors may not have the proper credentials — and urged fans to be wary of diagnoses off video alone — they are knowledgeable enough for what they are being asked to give out.
“If I was using purely the video to perform surgery on Kobe Bryant, that would be extraordinarily dangerous and frankly malpractice,” Souryal said. “However, if I’m looking at a video and I’m saying, ‘I think he ruptured his Achilles tendon, that’s what the video tape looks like it shows, and I wouldn’t count on him being back in the next four to six months,’ I don’t think there’s any harm in making that kind of speculation.”
Colts quarterback Daniel Jones was arguably the biggest surprise early on in the NFL season. Jones, once the longtime New York Giants signal-caller, led Indianapolis to an 8-2 start and drew early MVP buzz. But injuries in recent weeks led to a decline in his play, and things took a turn for the worse Sunday: He sustained a season-ending Achilles injury.
Shortly after the game, Natwa took to Instagram for a full video breakdown.
“We see him take a false step back,” he says, pointing to a slo-mo replay. “It’s where you start a step back and your ankle is put in an extreme acute angle, really loading the Achilles. As you’re pushing off, the Achilles has an increased risk of rupturing.”
Natwa said he doesn’t just want to give an injury label and a timetable. His goal is to educate with longer videos, even though it may take more work. He spends around 36 hours a week on football injury analysis.
It has led to some minor fame, though not in his own house.
“Some guy saw me in a coffee shop where we live, and he recognized me,” he said. “He was like, ‘Oh, man, you’re the fantasy doc.’ And [my wife was] like, ‘Oh, my God, is this that fantasy football thing that no one watches?’ And the guy at the coffee shop was like, ‘No, no. We all watch it. We watch his videos.’ She was so annoyed.”
Evan Jeffries, a physical therapist based in San Diego who breaks down injuries in all sports, not just football, has a bit more sympathy from his family.
“My kids think it’s funny. They love it,” he said. “They think I’m famous, and I tell them I’m definitely not famous.”
For Morse — who says he earns $25,000 to $50,000 per year on average analyzing football injuries — money isn’t why he does it.
“I’m a fantasy fan first, then I happen to be a doctor, and then I happen to be a specialist in sports medicine. I’m just crazy passionate about it. If you’re not, you don’t have the time to do this,” he said. “If you were to call up any random sports medicine doctor [or] orthopedic surgeon and say, ‘Hey, what happened to Jayden Daniels yesterday?’ There’s going to be like, ‘What the hell are you talking about?’”