“Ultimately, if I said a player couldn’t play, he didn’t play,” said Raymond Thal, a team orthopedist from 2000 to ’08. “Sometimes we’d say he can play, but the coach keeps him out because he doesn’t think he’d be as effective. But if I said he couldn’t play, the coach wouldn’t play him.”
There are rare cases still when medical expertise is overlooked or even overruled.
“I’ve been in that case,” said Tyer, who retired in 2009 as the Redskins’ director of sports medicine, “where I tell the coach two hours before a game when they’re making the list of inactives. I say, ‘This guy can’t play, coach.’ Coach is good with it. Then the player comes up to the coach and says, ‘Coach, I can go, I can go.’ You get ruled out of it sometimes.”
Redskins doctors agree that their relationship with players is key. The physicians all maintain regular full-time practices outside of Redskins Park. Most travel with the team and work on game days. In addition, they’ll visit the team’s training facility at least once a week, while the team trainers are on-hand to treat players every day.
“The issue of trust is really critical for us,” Casolaro said. “If the players don’t trust me or us as a medical team, it’s like any patient, it’s not going to work. If they don’t think I have their best interests at heart, it’s a rough road.”
The Redskins’ official health care provider is Commonwealth Orthopedics, an arrangement vetted by the NFL. In addition to James Andrews, the team’s high-profile orthopedic consultant, the Redskins use two area orthopedists — Chris Annunziata and Andrew Parker, both from Commonwealth — plus a team dentist, chiropractor and neurosurgeon. While the relationship could be a money-maker for some, it’s also a big time commitment.
“If you figure out your hourly rate, it’s not financially lucrative,” Thal said. “I make a lot more per hour being in the office of my practice than I do there. Does it help the practice? Yes, to some degree.”