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How Dr. Robin West handles when Redskins and Nationals players get hurt

How Dr. Robin West handles when Redskins and Nationals players get hurt

Dr. Robin West is arguably the most important figure in Washington sports that isn't (yet) a household name.

She became the director of sports medicine and lead orthopedic surgeon for the Washington Redskins this June. She also has worked as the head team physician for the Washington Nationals since October of 2015. In those capacities, she's the first female head physician in the NFL and the only one currently in the MLB. 

To give you an idea of that level of responsibility, consider that the Redskins and Nationals have a combined player payroll of $310,065,963 for 2016 alone, according to Sportrac.com. Now extrapolate that number out over the multi-year contracts on their books and you can appreciate the money at stake. 

Away from the professional sports world, West also runs her own practice and serves as the medical director of Inova Sports Medicine in Northern Virginia. She has a lot of hats to wear in a field that has fascinated her since childhood. 

In a piece for espnW, ESPN Injury Analyst Stephania Bell suggested that West could be the most influential figure in professional sports medicine today. The profile opened with West asking for the Gray's Anatomy textbook for Christmas when she was five years old. 

Bell, herself a physical therapist and orthopedic specialist, reports on athlete injuries. In some sense, these two women are counterparts on opposite sides of the process. One treats the injured athletes and the other reports those injuries and explains what fans can expect. 

My conversation with West tried to give Redskins and Nationals fans a glimpse of what she does on a daily basis and how she responds in an injury emergency. 

Though she has only worked with the Redskins for a few months, her job feels familiar. 

"I was in football for so long. I was with the Steelers for 11 years. I’m used to taking care of NFL players," she explained. "Obviously the teams are different in the sense of how teams are structured and how they’re run, but the players are the same."

But unlike her time in Pittsburgh, West has to balance her work with the Nationals, too. While the NFL season is in its infancy, the MLB season and its injuries are entering the home stretch before the playoffs.

The 89-63 Nationals are well positioned for the postseason, but have several medical question marks hovering: Will Stephen Strasburg be healthy enough to return to pitch this season? Is Bryce Harper’s slump related to some underlying health issue?

It’s a lot to deal with on top of the NFL grind. So the top doc relies on her medical staffs on both teams, including other physicians, athletic trainers and physical therapists. 

“Things I take from one team, I’ll bring to the other team, so that’s very helpful,” West said. “It works really well. You know [the players] certainly root for each other.”

So what’s a typical day like for her?

Most don’t start in professional sports stadiums. West has her own orthopedic surgery practice, so she treats regular patients most days of the week. She’s in surgery one or two of those days.

Her game day schedule is the outlier.

She has to report to Nationals Park about an hour before the first pitch in order to meet with players, then during play she either works in the training room or watches the game. She’ll stay for another hour or so after the game ends.

Game days with the Redskins are much more regimented. West gets to FedEx Field about three hours early to see players in the training room. Then it’s time go out on the field, where she watches the players in the game. She’s also around for about an hour after the final whistle.

How West responds to injury emergencies – say Strasburg feels a pull or DeSean Jackson stays down after a hit – also depends on which team she’s treating at the time.

Baseball gives the head physician more time to react and evaluate an injury than football does. It’s the athletic trainer who goes out onto the field with the player, then brings them into the dugout or training room for West to evaluate.

“I have a little bit of time in baseball to look at the injury, look at the replay, look at the player. I have a few minutes there,” she said. “In football you’re running out [on the field], the injury just happened. You may or may not have seen the play because there are a lot of things going on down there.”

Baseball players and football players often get hurt in different ways, too.

“Major League Baseball is more of a year-round season, so they’re playing longer term. We’re seeing a lot of chronic overuse injuries,” West explained.

“In football, you see a lot of acute injuries. More traumatic and acute injuries, versus baseball where it’s a lot of overuse, repetitive type injuries.”

When it comes to diagnosing the problem, West’s knowledge of her patient as an individual is her secret weapon.

“Patients can mislead you because some patients are tougher than others or complain differently.

“It’s important to know the players so when you get out there on the field, or in the training room or dugout, you know the players and how they’re going to respond to pain because you have to do a quick assessment. Are they safe to return to play?”

If the hurt player does need some kind of orthopedic surgery, it’ll usually be West that performs the operation. Sometimes she’ll think another doctor is a better choice for the procedure and refer her patient to them.

A good rapport with players is equally critical to treating as diagnosing them because there’s a mental element to recovery and rehabilitation.

“As an orthopedic surgeon, we can fix [a player] surgically, but we have to also think about everything else,” West said. “On the mental side, a lot of teams have sports psychologists. So we can work on the mental side and visualizing the recovery, visualizing the return to play and high level of play.

“I think it’s really important, the initial response to the injury by the orthopedic surgeon, that it's a positive experience.

“You want to say, 'Hey, you have a great chance of recovering. You’re a high level athlete, you’re going to have great care around you and we’re going to get you back.'”

West also noted that she doesn’t think being a woman has negatively impacted her ability to gain the confidence of players in a male-dominated environment. Her gender might even help.

“I don’t think I’m treated any differently. And maybe some players seek me out because I am a woman. Maybe they think I’ll have a softer side or something,” she said.

That softer side is important when comforting players with very serious injuries. I asked West what she considers the most difficult injury she’s treated and why.

Knee dislocations with damage to multiple ligaments was her answer. And not just because it’s tough for patients – it’s hard on their doctors, too.

“When somebody dislocates their knee and they have a year to year-and-a-half of recovery, nerve injury, those are hard cases because most of these guys want to get back as soon as possible.

“And if you have a long-term injury that you’re dealing with and trying to rehabilitate, those can be trying for the athlete as well as for the medical staff.”

When I spoke with Bell the same day, she also named knee dislocations as one of the worst injuries she's seen. 

“Knee dislocations are one of the most brutal injuries, not only visually. When you see them it’s very disturbing because it looks grotesque. Frankly, it’s something your brain’s not used to seeing.

“And then there’s all the risk that’s involved with the potential injury, not knowing what the future of the player is going to be,” Bell said. “There are a lot of blood vessels involved and nerves involved and you’re talking about the health of a player’s leg for the rest of their life, not just for their ability to return to sports.”

She said covering South Carolina running back Marcus Lattimore's comeback from a knee dislocation, in which he suffered multiple ligament damage, was one of the most compelling stories of her career. 

My conversation with West wrapped up with her sports allegiances and whether she considers herself a fan of the Redskins and Nationals.

West noted that while she cheers for the players because she wants to see her patients do well, she isn’t actually employed by the teams. She’s independent so that she can keep the best interests of the players as her top priority.

You might be wondering why I didn't ask West for updates on Strasburg’s recovery or what’s really going on with Harper. Because of the nature of her work, she can't answer questions about specific players, but the interview gave me a good idea of how in-demand she is. 

Our 20-minute conversation was interrupted twice by phone calls. One was urgent, something about an MRI. She had to take it. The other she seemed comfortable to let go for a moment.

West politely explained why working in professional sports means constantly checking the phone. 

"When you have players on the road, they get injured and I have to be in communication." 

RELATED: ANOTHER TOUGH WEEK FOR HARPER

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Need to Know: The Redskins week that was—All-Redskins mock, fast-fading interest in Dez

Need to Know: The Redskins week that was—All-Redskins mock, fast-fading interest in Dez

Here is what you need to know on this Saturday, April 21, five days before the 2018 NFL draft.  

The Redskins week that was

A look at some of the most popular posts and hottest topics of the week on Real Redskins and NBC Sports Washington

Should the Redskins pursue Dez Bryant? This topic was one like a meteor, very hot for a short period of time before it quickly faded out. It started to heat up as soon as the Cowboys cut Dez (about a month too late) and when it was reported that he wanted to play against Dallas twice a year it really picked up steam. But then people started to actually think and figured out that signing Bryant didn’t make much sense for the Redskins. Add to that the reports that the Redskins had no interest and would not look into signing Dez in the future and the Redskins fans quickly lost enthusiasm for the topic.

Seven-round Redskins mock draft—I think that most Redskins fans would be happy with this mock. Well, I’ll say some Redskins fans, most is a pretty strong word in this case. 

Is the draft pool deep enough for the Redskins to trade back? There is plenty of talk about the Redskins trading down in the first round to recoup the third-round pick they gave up in the Alex Smith trade. But they need to be careful. Many consider the draft to be top heavy and they may lose their chance to pick up an impact player if they trade back too far. The question then becomes one of quality vs. quantity. 

Three questions as offseason workouts get underway—There will be plenty more questions that we can ask about this team. But we don’t really know what to ask before the draft, particularly when it comes to the defensive line and running back. One the personnel settle into place we will know what we don’t know. 

Tweet of the week

On Chris Cooley’s thought that the Redskins might try to trade back and get Da’Ron Payne in the draft and the use the assets obtained to move up to get Derrius Guice. 

This is related to the questions about trading back. On paper it looks like a good idea, assuming the Redskins want Payne. We’re pretty sure they would like to have Guice but we haven’t heard as much about the Alabama defensive lineman. 

I had many reply that Guice won’t be there in the second round. It’s possible, perhaps even likely, but you just don’t know. There was zero chance that Jonathan Allen would be there at No. 17 last year, right? 

Stay up to date on the Redskins. Rich Tandler covers the team 365 days a year. Like his Facebook page, Facebook.com/TandlerNBCS and follow him on Twitter  @TandlerNBCS.

Timeline  

Days until:

—OTAs start (5/22) 31
—Training camp starts (7/26) 96
—2018 NFL season starts (9/9) 141

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Redskins' schedule "rest disparity" is very fair in 2018

Redskins' schedule "rest disparity" is very fair in 2018

The NFL started taking into account a new factor when putting together its schedule this year. The concept is called rest disparity. It stems from a complaint made by the Giants last year. And, of course, when the Giants have a cold, the NFL sneezes and immediately does whatever it takes to cure the cold. 

Here is how Peter King laid it out this morning on the MMQB:

Last year, I heard the Giants were not pleased with their schedule because they felt they were too often playing teams more rested than they were. In consecutive October weeks, they played teams coming off byes, for instance. The NFL calculated a figure for every team based on the number of combined days of rest for their foes or for the team, calculating, for instance, in those two weeks, the Giants were a minus-14 (minus-seven for each of the foes, Seattle and Denver, coming off byes). In all, by my math, the Giants were a league-worst minus-22 in “rest disparity.”

So the schedule makers worked to minimize the rest disparity this year. According to King, the worst rest disparity in the league this year is minus-11. The Giants are minus-eight. 

The question that Redskins fans will have immediately here is if the Giants’ rest disparity was reduced at the expense of the team in burgundy and gold. The answer that will surprise many is no. 

The Redskins rest disparity in 2018 will be either minus-one or zero. The variance is due to the possibility that their Week 16 game in Tennessee will be flexed to a Saturday game (see details here). If the game stays on Sunday, they will be at minus-one in rest disparity. If it gets moved, they will have had exactly as much rest over the course of the season as did their opponents, in aggregate. 

If you're interested in the nitty-gritty, here is how it breaks down. In eight or nine of their games, they will have had the same amount of rest as their opponents. They play one game coming off of their bye, a Monday night game in New Orleans. The Saints play the previous Sunday, giving Washington a plus-seven in days of rest. That is canceled out when they play the Falcons in Week 9 after Atlanta’s bye. 

Due to their Thanksgiving game, they get three extra days off going into their Week 13 Monday night game in Philadelphia. Two weeks later the Jaguars will have those three extra days of rest when they host the Redskins, having played on Thursday in Week 14.

They lose a day relative to their opponents coming off of those Monday night games against the Saints and Eagles. The Redskins get an extra day prior to visiting the Giants in Week 8 as New York has a Monday night game in Week 7. 

So far, that comes to minus-one in rest disparity. That will remain in place if they play the Titans on Sunday, December 23. If the game is flexed to Saturday, they will gain a day of rest on the Eagles in Week 17, zeroing out the rest disparity for the season. 

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Stay up to date on the Redskins. Rich Tandler covers the team 365 days a year. Like his Facebook page, Facebook.com/TandlerNBCS and follow him on Twitter @TandlerNBCS.