How doctors and experts are diagnosing sports injuries on Twitter

Meet the guys betting their professional reputation on being right.

Mar 1, 2020, 4:55 am*

Internet Culture

Josh Katzowitz 

Josh Katzowitz

It was about eight weeks into the 2013 season, and Dr. David Chao was on his couch watching an NFL game. Up until two months prior, Chao had been employed as the San Diego Chargers team doctor. Had worked as the team doctor, in fact, for the previous 17 years.

But he was 50 years old and newly married. He had just undergone his third back surgery. He had twins that were about a year old. And frankly, the process of taking care of the Chargers players simply wasn’t as fun as it used to be for Chao. So, he resigned and moved on with his life, taking care of his wife and kids and continuing his work as an orthopedic surgeon.

He left football, but football hadn’t left him.

Chao found himself on the couch a couple months later, watching football and diagnosing the injuries of the players from his TV. Chao had a family audience of three, two of whom couldn’t understand him anyway. And the other had no interest in listening to his analysis.

“I don’t even have a Facebook page; I’m not a social media guy,” Chao told the Daily Dot. “But I didn’t know why the TV announcer was saying that this player’s ankle was hurt when it was really his knee and [that player] wasn’t coming back to game. My wife said, ‘Why are you yelling at me? …Honestly, tell it to someone who cares.'”

Then, she signed up Chao for Twitter. Almost immediately, his newest hobby was born.

Unlike Chao’s wife, there are actually thousands of people who care about Chao’s opinion. He’s got nearly 19,000 Twitter followers, and he writes a Monday morning weekly column for the National Football Post in which he analyzes the previous week’s injury news. In the process, he’s helped carve out a niche for sports fans on Twitter. Chao can watch a game—be it, football, hockey, or baseball—and in real time, he can predict the injury a player has suffered and how long his recovery time might be.

Chao is not a reporter. He’s a doctor who has built up a list of people who take value in the fact that Chao sits on his couch and tells them—the team fans and the fantasy football engagers—what’s happening with the players they care about.

“My mantra,” Chao said, “is that I have insider knowledge, not insider information.”

Will Carroll has insider knowledge as well, but he’s the first to tell you that he’s not a doctor. Carroll instead is a journalist who’s previously worked for Sports Illustrated, Baseball Prospectus, and Bleacher Report and who’s now employed by FanDuel. But Carroll has been around sports medicine for much of his life, and that allows him to explain an injury to his readers (and his nearly 40,000 Twitter followers) in terms they’ll understand.

Carroll is not a doctor. He’s a reporter who has the inside information and then uses it to break news.

“I’m a translator,” Carroll told the Daily Dot. “People don’t know what a Grade 2 MCL sprain is. I go back and forth between saying I’m a translator and I’m an educator. I teach you what a sprained ankle is, and you’ll understand it more and you can understand why your favorite player didn’t come back from it today.”

Chao and Carroll are buddies, and they don’t necessarily compete against each other. More accurately, their work complements the other, and together, they’re part of a niche that we didn’t even know we needed, say, a decade ago.

We don’t see much of that on TV broadcasts, though NBC sometimes utilizes the services of former Jaguars head trainer Mike Ryan. But the networks have been analyzing and grading the game officials and the calls they make—particularly with Mike Pereira on Fox and Mike Carey on CBS—and it seems only a matter of time before a network brings an injury expert into the booth to provide real-time injury analysis.

For now, though, Twitter is the frontier. Which leads us to this question: Could having these conversations and making these declarations on Twitter hurt the reputations of a respected journalist like Carroll or an accomplished physician like Chao? Especially if they’re wrong more than they’re right?

When during the 2013 season I discovered Chao’s Twitter account—which he uses authoritatively to convey his predictions in a matter of seconds—I immediately thought of Bill Frist.

In 2005, the former Republican U.S. Senate Majority Leader who happens to be a heart surgeon, declared that Terri Schiavo—a Florida woman who suffered a cardiac arrest in 1990 and, ultimately, brain damage—was not in a persistent vegetative state. The problem was that Frist had never examined Schiavo in person. His only contact with her was watching her on videotape for an hour in his Senate office. After she died, an autopsy performed showed she did, in fact, suffer from severe, irreversible brain damage, and Frist received plenty of negative attention for inserting himself into the controversy (Frist actually made his speech on the floor of the Senate) and for giving his incorrect opinion from 900 miles away.

Chao makes no apologies that he’s watching the games on TV. And even though there might have been credibility issues when he first joined Twitter because of a list of accusations about his competency and because the NFL players union had questioned his qualifications to be a team doctor—Chao said he was exonerated from any allegations thrown his way, and he still has his license and practices medicine—he makes a solid case for why he’s a credible source of information.

“Whenever the quote unquote ‘heat’ was on me with the Chargers, I knew the heat wasn’t real,” said Chao, who said he was advised by the team not to defend himself at the time so the controversy would “blow over” faster. “I could lay my head on my pillow at night… How did I hold the Chargers job for 17 years if I was some schlock who wasn’t doing a good job? It defies logic.

“The credibility [on Twitter] is earned over time. My guess is some people still don’t look at me as credible, but my guess is that a lot of people do… I don’t pretend to know all. I’m saying it’s insider knowledge. I know that world, and I know how to treat them. Am I factual? I can’t be. I’m not examining the player. Am I credible? I’m credible with my background. But remember it’s my opinion. I’m comfortable with the credibility issue now.”

Chao said that when he gave his opinion on Twitter about a player’s injury last NFL season, he was right in 137 out of 148 cases (that’s a successful prediction rate of 92.6 percent). He doesn’t know if his measurements of his own work are completely unbiased—he did offer to let the Daily Dot perform its own audit—but he knows why he’s right so often.

During his 17 years with the Chargers, he would return to team headquarters every Monday morning after a gameday. After he reexamined an injured player and looked at his X-rays and MRI results, Chao would watch the game film.

That way, Chao said he “could go back and reverse engineer everything” related to the injury.

That’s how Chao knows, just from watching a replay from his couch, the injury that’s been sustained—he saw enough of them during the previous 17 years to be precise in his declarations. That’s how he could tweet something like this just before last year’s NFL playoffs just by watching game and practice film of the two quarterbacks in question.

Considering it was later revealed that Manning had been playing with a torn quadriceps muscle, Chao was correct in his assessment. Fans might not have believed it at first, but now, there’s a niche for those who want to know all the injury information as soon as possible. 

That’s why people, minus Chao’s wife, care. That’s why Chao can watch from his couch in San Diego and why Carroll can tap on his keyboard from his place in Indianapolis and make the football-watching public comprehend what could be in the immediate future for an injured player.

“The leagues have done such a terrible job of educating their fans about injuries. The leagues have been way behind,” Carroll said. “If leagues would let their medical personnel tell everybody what’s going on, people would enjoy it and it wouldn’t hurt the players one little bit… There’s just a demand for it, whether it’s fantasy players or just fans. People want to understand.”

Illustration by Max Fleishman 

Share this article
*First Published: Apr 28, 2015, 2:00 pm