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July 9, 2014

In Conversation: Dr. Guy Pt. II

In part two of Gamecock Central's conversation with USC Sports Medicine director Dr. Jeffrey Guy, he talks about Marcus Lattimore, Connor Shaw, Steve Spurrier and how the overall sports medicine program has grown from treating no USC athletes to treating them all, becoming along the way a national model for care and service.

Gamecock Central: Looking over your tenure since 2001, what sticks out to me as a case where your expertise was critical was in the career of Marcus Lattimore. That moment in the Tennessee game two years ago when he injured his leg so badly had to be very difficult for you personally. You two were very close; can you describe what that was like being on the field?

Dr. Jeff Guy: In that game, Marcus had scored a touchdown right before that injury. If you look at people coming back from ACL surgeries, it's not just my suspicion but is borne out in the research, there's a big psychological component to it getting your confidence back.

The first time he got hit by somebody was in the Vanderbilt game the first game of the season and he actually fumbled. I told him, "You probably didn't realize you had the ball." That's natural the first time you get hit after coming off a significant injury. As part of our rehab process with our athletes, Clint Haggard who is our head Football athletic trainer, tries to simulate as much as possible before returning athletes back to full contact. They use large pads and bump into them during drills. You do all that you can to simulate reality, but its not the same as getting hit in a game. In addition, we probably don't hit as much in practice as some programs because coach (Steve) Spurrier believes in keeping his kids healthy, which is great.

The Tennessee game, we were on the sideline talking and when Marcus scored that touchdown it was the very first time he looked 100 percent. When watching athletic events, I think team physicians and athletic trainers have to develop a different vision of how you look at a game. You learn to look for abnormality of motion.

So when people get up slowly or limp off the field or throw the ball funny or they do something different, that's what you're attuned to. So we made a comment that that was the very first time that Marcus looked like he was running like the old Marcus. Before that he was doing good, but you could tell he just didn't quite have 100% of his confidence and power quite come back. That touchdown was the first time he looked like himself.

GC: And then, disaster.

Guy: The way the play happened, I can still hear it. As a medical staff on the sideline, we all wear earphones on the sideline for communication. From where I was standing on the sidelines I was actually blocked from the play, so I didn't actually see it. But Clint, our head athletic trainer, all I heard was him saying, "Dr. Guy!, Dr. Guy! Dr. Guy!" It seemed like he said it 10 times when Marcus went down.

Going out there, you know it's a significant injury. So we attended to his leg. Time kind of stops. The biggest thing right away was Marcus was in shock. We tried to stabilize his leg to get the whole process started, but as you can imagine with most kids, especially kids coming back off an injury and getting back to full speed, one of the things he was saying, I don't even think I can do this again.

Obviously we had tears coming to our eyes, he had worked so hard to come back, but you then kick-in to medical mode and we stabilized him and got him off the field and got him out of the stadium as quick as we could to the hospital to continue his evaluation and to be with his family. Wasn't to long after that Marcus was ready to take on his new challenge, always a positive person.

GC: What's your relationship like with him, having worked so closely with him for so long?

: He's an amazing kid. He has an amazing aura, if you want to call it that, an amazing way with people. People gravitate to him in a way you rarely see.

GC: In another case of a high-profile athlete, Jadeveon Clowney, what was it like with the case last season where much was made of whether or not he required or should have had surgery on his ankle before the season? What was that process like?

Guy: Jadeveon actually was really easy. Most of his injuries were not anything that we had to do anything special about, it was mainly giving him a rest here and there. He didn't have any major injuries while he was here. I think the ankle thing got blown up out of proportion and was more in the media than it was in reality.

It was never anything that required a significant surgical discussion. He' had problems with it growing up, but he never had to have surgery on it while he was with us, and his feet now are doing fine. Professional teams, do an incredible thorough job at the combine. Those teams shake those kids upside down to try to find injuries, and none of it was a concern.

In fact, we sent Jadeveon to our foot and ankle consultant to take a peek at Jadeveon and he said, "He's fine." There was no concern there.

I think we have built a system, over the last 10 years or so, that our athletes get the great care. We have amazing training room facilities and staff, and amazing athletic trainers that care for our teams. Our team doctors are available for the athletes and we have a great consulting system. If someone isn't getting better, we utilize our consultants. We hope that our athletes know we're going to try to get them the best care possible.

It's the same system we use on our high school kids as we have for Marcus Lattimore and Jadeveon Clowney and our USC athletes. If a high school kid gets hurt, or someone from Benedict or South Carolina State, they have the same opportunities for care.

GC: You have the benefit of being on the sidelines for every USC football game. What are some of your best memories?

Guy: Trying to take care of Connor Shaw. Connor is an amazing athlete. Connor is a tough kid that doesn't like being injured and wants to be back to play. Trying to get him to back off or slow down was very difficult.

Its an attractive part of an athlete, when they're tough and can play through pain. We want them to go back safely and we won't let them play and risk further injury. However, not everyone is a Conner Shaw. Clearing athletes to return to play can be difficult. You have to combine your clinical opinion with the collective input from the strength and athletic training staff. You also have to learn frame of mind that the athlete may be in coming off an injury. Connor is just a really tough and confident athlete who had some interesting injuries, some of which were pretty big.

GC: The Missouri game this past year seemed one example of that, where he was both injured and sick.

Guy: That was an interesting game for people to understand. There are two different sides of the story and they don't necessarily have anything to do with the player. I can clear somebody for participation. I can't tell coach Spurrier, "You can put him in for five or six plays only." Either they're cleared to play or they're not, and then it's up to the coaches to decide whether they play or not.

Connor was cleared to play, but coach Spurrier and the coaching staff decide whether or not he could play. It can be a difficult decisions for coaches especially if an athlete hasn't practiced all week. So just because we clear someone doesn't mean they'll play.

Sometimes it'll be a game-time decision where we'll examine someone in pregame warmups and let the and then the coaches wait on word from us. In the Missouri game, Connor looked pretty good coming back from his injury in terms of being able to play safely , he was just very sick and still a bit sore. Of course, he didn't practice at all that week leading up to Missouri.

With a bruise, we weren't concerned about making it worse, it's just very painful and limits your mobility. So he was cleared physically. In Connor's case, playing at Missouri, the amount of pain and discomfort he played with was remarkable and to do what he did. I still can't believe the pass he threw to Bruce on fourth-and-15.

GC: What other games have stood out in your career on the sidelines?

Guy: Definitely the Alabama game (in 2010). That was a big one. At the Outback Bowl, I was probably standing within seven-to-10 yards when Clowney hit that kid from Michigan, the thud of the helmet, watching it fly off. The Florida game to clinch the SEC at Florida was great, winning in the Swamp. While I wasn't there, the World Series wins by Coach Tanner and the Gamecock Baseball team were pretty fantastic.

But I'd say that Alabama game was the biggest one.

GC: Is there every any pressure nowadays to return players to competition before they're ready like there once was?

Guy: Not at all. Coach Spurrier, Dawn Staley, Coach (Frank) Martin, Chad Holbrook and for that matter, all our coaches, we literally have the best coaching staff with regards to injuries.

Coach Spurrier is very much a "Tell me who's ready" coach and then he plays with who he can play with. He knows you can't control the other stuff. He's great. When Connor got hurt, he was like, "OK, Dylan, you're in." That's how he is.

GC: Is it ever difficult to know how badly someone is really hurt versus how much they say they're hurt?

Guy: It can be tough to figure out when kids are hurt, when they're not hurt, how much they're hurt and how long they'll be out. It's a cycle of constant evaluation and trying to get people better. We have great Athletic Training staff. On a day to day basis, they are the heroes that work behind the scenes to keep our athletes healthy. They stay on top of where people are physically and mentally. We couldn't do it without them.

GC: How much does the communication between the doctors and strength and conditioning staffs help prevent injuries?

Guy: The best thing is that the medical staff has a great rapport with the strength staff. A long time ago the strength staffs and medical staffs really didn't talk much. The way they train now, they do a lot more alternative work outs and not just lifting in the weight room.

That has definitely knocked down the injuries. We definitely don't see the weight-room injuries like we used to. Clint and Joe Connolly do great work communicating and working with the student-athletes. What also helps is that once a year we have a medical review, right before the Spring Game, where we meet with all the physicians, athletic training staff and all the coaches. We have done it since Lou (Holtz) was here.

We take and hour and we present all the injuries from the previous year and compare them to previous years. We show them all the statistics of how many surgeries we had, what type of surgeries and injuries and talk about things such as what's the difference between a high-ankle sprain and a low-ankle sprain. We'll pick a topic that's popular, maybe ACL tears, and discuss it.

All the coaches come, and seem to enjoy it. It's pretty exciting. We show the videos from surgeries, X-Rays, Scans, MRIs, you name it. It's helpful for them to see what we see, and they understand it better. It's a great interaction and talk and helpful I'm sure for both sides.

GC: What are the most rewarding aspects of your job?

Guy: For me by far the most rewarding aspect of my job is that I love to see the system work. As medical director, I have the pleasure of working along side a really amazing group of people. Our head athletic trainer John Kasik and our entire athletic training staff that care for our athletes. Jim Mensch, Toni Torres McGhee and Jeremy Searson that work tirelessly on our academic side training our future athletic trainers. Our team physician and partners Drs Mazoue, Walsh, Holloway, Jenkinson and Pollack that round out our medical staff. The USC Sports Medicine office staff especially Kevin Herod that coordinates communication with all the components of care. Again, it takes a lot of collective effort to provide the care that we do. Again, I work with some very special people.

Having Eric Hyman have the doctors over and say to us "Hey, I've been to this many other places for a number of years and I know I never have to worry about Sports medicine here." That stuff doesn't make the paper, but it's great to hear and know. It makes you feel good. Our guys work really hard and there's a very supportive atmosphere here.

Coach (Ray) Tanner, Charles Waddell, Eric Hyman when he was here, president (Harris) Pastides, there's so much support here and in the community. Our sports medicine network is also built in partnership with Palmetto Health. They have also continued to support the growth of Sports Medicine.

When I first came here, those partnerships didn't exist. Everyone was an island unto themselves. USC has a medical school, a nursing school, exercise science department, athletic training, physical therapy student health, so many different components, one of everything, really, but nobody talked to each other when we first got here. We have the number one Ph.D. program in the country for exercise science, but our system wasn't utilizing it. That's gotten so much better and the level of support and the great people we have are exciting to be a part of.

I had a former player who has played for the San Diego Chargers, Byron Jerideau, text me on Father's Day. He said, "Hey Dr. Guy, happy Father's Day!" I texted him back jokingly and said, "I'm not a father, I don't have any kids," and he said, "I know, but you're like our father because you take such good care of us kids. We really appreciate it." That means a lot.

Jonathan Joseph, who is playing with Jadeveon in Houston, we fixed his foot when he was here at Carolina. When he broke his other foot a few years back with the Bengals, he had the Bengals fly him back here to do his surgery because he said we did such a great job with his other foot he didn't want anyone else to do it. You try to take care of people the best you can and hope that they appreciate it and want to come back. They're all welcome to come back. These are the things that make being a team physician all worthwhile.

Editor's note: The interview with Marcus Lattimore about Dr. Guy, his relationship with him and what it was like going through the moment of the Tennessee game injury will go up at 1 p.m. today (Wednesday). Stay tuned!

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