As team physician for the US Men’s National Soccer Team, Dr. Gerhardt’s
position has called on him to travel the world, bringing him “from
the snow covered fields in Germany to 110° temperatures in Mexico
This past October, Dr. Gerhardt was with the team for the CONCACAF Final
closer to home, at the Pasadena Rose Bowl. After an exhilarating US vs.
Mexico match, Dr. Gerhardt spoke with us about his experience as team
physician for the USMNT.
How long have you been working with the USMNT?
I’ve been the USMNT team physician for twelve years. Dr. Bert Mandelbaum,
who has cared for the team for over twenty-five years, recruited me to
the medical team shortly after my Sports Medicine Fellowship. I’ve
worked with the team through three world cups, with three different head
coaches, and with many of the best players to ever don an American jersey.
It has been a real honor to help care for these athletes and to help this
team be successful.
Treatment of USMNT is high profile. When an injury occurs, there is pressure
for return-to-play, consideration of media coverage, etc. Talk about the
added pressure and how you handle it.
The athlete’s health and safety is
always first priority. There are certainly extrinsic pressures that loom over
medical decisions, both on and off the pitch, but the doctor-athlete relationship
is of the utmost importance. Always. Without this trust and this relationship,
the best interests of the team and athlete will eventually be compromised.
Open and honest communication between all parties - the athlete, the coaching
staff, management, agents, and other members of the medical team is critical
in maintaining a strong sports medicine program. When communication is
good between all parties, it makes hard decisions much easier.
What other challenges, if any, are specific to treating the USMNT?
One of the challenges unique to the USMNT, and all national teams, is that
these athletes only come together intermittently and usually for brief
periods of time. Each player has commitments to fulfill with their respective
professional teams, scattered all over the world. The national team coach
is sensitive to the players’ time and keeps them only for a short
duration to train with the US team.
Players are constantly coming and going, so I have just brief periods of
time to assess the health and fitness of the players. While many of the
athletes are fit enough to compete, it’s not uncommon for them to
be struggling with minor ailments, which need to be monitored and factored
in to their ability to compete effectively for our team. The best way
to manage these situations, again, is to communicate with the player,
the trainers, and the coaches to make sure the athletes are optimally
prepared to compete at the highest levels come game time with the USMNT.
In the week leading up to a big match like the CONCACAF Final, what are
the top three points of preventative care you would advise to soccer players
to ensure they’re in top shape come game time?
Fitness is always the most important factor as soccer is a grueling and
intense test of endurance, particularly when played in hot and humid conditions.
Most of these athletes already come in to camp with a solid base of fitness,
so training is geared toward maintenance of the fitness base while also
ensuring that the players are not “overworked” and fatigued
going into the match.
Programs may vary from player to player, depending on variables of whether
the athlete is coming off injury or perhaps is coming off a grueling stretch
of games with their professional team. These factors are discussed with
the coaching staff going into a USMNT camp and workouts can be individualized
and tailored to a large degree depending on the situation and how long
our players are in camp leading up to the game.
Nutrition, hydration, and acclimatization to the local environment are
the other three most important factors to optimal performance. Our coaching
staff and medical staff put these factors at a premium when preparing
our athletes for a game like the CONCACAF Final. The team travels with
a full time chef who is focused on optimal nutritional performance for
the soccer athlete. Hydration is monitored with daily urine checks leading
right up to game time and any deficiencies are corrected. Acclimatization
to the local conditions is also important. Practices leading up to game
time are conducted at times that best replicate the conditions when the
match will be played. Acclimatization is critical particularly when conditions
are expected to be extreme such as high humidity, extreme temperatures,
and high altitude.
What are the top three injuries you see on the field and what is the most
important factor for treatment?
The most common injuries in the soccer athlete involve muscle strains,
ligament tears, and joint sprains. Specifically, hamstring muscle strains,
ankle sprains and medial collateral ligament strains of the knee.
These injuries can range in severity and, since the athlete is only with
the USMNT camp for a brief period, it is critical that the injury is evaluated
by the medical staff and that appropriate diagnostic tests be arranged.
We can then quickly decide whether this is an injury that the athlete
will recover from quickly and if the athlete will be able to compete or not.
I am available 24 hours a day and 7 days week for these athletes and have
set up a medical program such that x-rays, MRIs, ultrasound machines,
and other necessary diagnostic tools are immediately available to our
team. That being said, these resources become harder to arrange if the
game is played in a country such as Nigeria where technology may not be
readily available. For this reason, we travel with a complete set of medical
gear including a portable ultrasound so that detailed information about
an injury can still be assessed and decisions can be made.
How has playing soccer competitively yourself given you insight in to soccer-related injuries?
Having played soccer for many years, I understand the nature of the game,
the injuries, and the importance of certain situations, bringing an extra
layer of insight to our medical program. Having first-hand understanding
of the requirements of the players to be able to compete at a high level
helps make decisions in high-pressure situations easier.
I have developed relationships with many of these players and coaches over
the years and with that comes a sense of trust and understanding. They
know that I am here to help in any way I can to help keep this team healthy
and fit. In many ways, this team feels like a big family – which
is a nice feeling when we are half way around the world in tough conditions.
What was the most memorable part of the CONCACAF Finals match?
US v. Mexico games are always special because of the intensity and history
as neighboring soccer countries. This game had all the intensity and importance
as any game we have played. It almost reminded me of a World Cup atmosphere,
which was fostered by the stakes being high. Qualifying for the Confederations
Cup is a huge reward that both teams wanted badly.
For me, the highlight of the match was watching Bobby Wood enter the match
late in the game and quickly making his mark by scoring a beautiful tying
goal. This made the game 2-2 and at this point we really were pressing
the Mexican team, nearly scoring again on a couple of occasions. Just
when we thought the game would surely go in to overtime, the Mexican striker
scored a world-class goal to close us out. It was a heartbreaking loss,
but a game I will never forget.
Now, it’s time to reset and focus on the next challenge, which is
qualifying for the 2018 World Cup. Those games start this fall and the
team is already setting its sights on this process.