Q&A: Doctor with Pro Football Pedigree Treating Sports Injuries in Bennington
She just might be a former professional football player, too.
Earlier this winter, Dr. Ivette Guttmann joined the staff at Southwestern Vermont Medical Center as a sports medicine specialist.
Guttmann is board certified in pediatrics and primary-care sports medicine.
And she is a bona fide football hero, having set a record for touchdown completions in a season as a quarterback for the Orlando Starz and in the Independent Women's Football League.
"I wouldn't necessarily describe myself as an athlete," Guttmann says. "I wouldn't necessarily describe myself as a physician. I would describe myself as a physician/athlete."
As a doctor, her experience includes work as a team physician at the University of Miami, near where she grew up and as part of the medical staff at Giants training camp in Albany, N.Y.
As a jock, she was an all-star in multiple sports in high school. None of those sports were football — that came later — but her life experiences on the gridiron and in the gym and on the softball diamond help make her a better physician.
"They're totally intertwined. If someone comes in and says, 'I sprained my ankle when I was coming down on a jump shot,' I've been there," Guttmann said. "I'll say, 'Did you step on somebody's foot?' because it's a different mechanism of injury than if they just hit the floor.
"Then I know what they're going to want to sneak off and do. So when I start to rehab them, I'm like,
'Listen, no jump shots. You can't do jump shots. You can't do any shots beyond the foul line. Don't be doing shots on the perimeter. No layups because you're jumping.' I can kind of talk the talk, which I think is helpful for them. They can kind of relate and, hopefully, obey.
"That's the hardest part. Compliance."
Guttmann sat down with iBerkshires.com recently to talk about her work at SVMC, her athletic career and the state of the game she loves.
Question: Were you still in school or were you practicing medicine when you started playing pro ball?
Guttmann: I was out of med school. Out of med school but before residency.
Q: So were you taking a break to play ball or did you continue playing while you were doing your residency?
Guttmann: I took a break.
Q: For how long?
Guttmann: Three years. I took a break for three years.
Q: Why did you decide to interrupt your medical career at that point?
Guttmann: Because my first love was always sports, and sports got me through life, and it has always been extremely rewarding.
Even in the field that I'm in now, I find it very rewarding to not just help athletes get back in the game but also help the weekend warrior or your arthritic patient or your patient who hurt their knee or has a bad back and it's still logging season.
I find it rewarding to help them get back into it.
Q: We think about sports medicine in the context of team sports, high school kids, college kids. Have you seen in the time you've been doing it more of a shift toward the weekend warrior, the person in their 50s or 60s who hasn't played sports and decides to get into it later in life?
Guttmann: I'm a sports medicine physician. But if you asked me what do I do, I will tell you that's a misnomer because I don't just see athletes. I see non-operative orthopedic, musculoskeletal injuries — arthritic knee or hip, fractures, knee injuries, shoulder injuries, wrist injuries — any kind of pain, strain that does not require surgery. I'll see them.
So this doesn't exclude everyone who is not an athlete.
Everyone is an athlete at heart, whether they're gardening or they are walking and they get injured and they want to get back to what they're doing, whether they're a housewife or whatever. You have to keep going every day.
If you think about it, life is a sport, isn't it?
Q: you not because they're running or skiing or doing those kinds of things we think of as potentially injurious? They're doing more day-to-day life stuff? Or is it a split somewhere in there?
Guttmann: It depends where I'm working. Where I came from [Florida], it was extremely athlete- and sport-related, maybe 75 percent of the people I was seeing were the true athletic people — runners, triathletes, college athletes.
Here, we've shifted a little bit, and now you see just your run of the mill, your skier, biker, runner. It's a little bit more variety. I see more of a wider spectrum of patients here in Vermont, which I like.
Q: Are the patients you're seeing typically people who need long-term treatment under you, or do you get them started and then pass them off to physical therapist situations.
Guttmann: I don't pass off my patients.
Q: I apologize. That was the wrong phrase.
Guttmann: Actually, some physicians do, but I'm one who keeps them until they get better. They either get better with me or they get better with me. Unless they need surgery, then I will refer them to a surgeon.
Physical therapy — as you know I'm very much into football — so physical football is my offensive line. I'm only as good as my offensive line. To me, it's important to pair myself with good physical therapists. Because if they can't work with my patient and help them and assist them into rehabbing what we need to help them on, at the end of the day, I'm no good.
Q: You just used the offensive line metaphor, so getting back to your football career … You said sports were your life. When did football come into your life, organized football, not just messing around with your friends on the lot?
Guttmann: I used to play street ball in the neighborhood. My dad was the quarterback for all the kids in the neighborhood. We lived in a cul de sac. And my dad watched weekend football, and I was there. I knew everything about football before I knew how to divide in math.
That was my favorite sport, even though it was never truly available to women until I became aware of it, which, unfortunately, was a little bit later in life than I would have liked. It was obviously after my medical school studies.
My mom actually brought it to my attention. She said, 'Remember Lisa So-and-So, who you used to play softball with? She's playing football.' I was like, 'What kind of football? Flag football? [Rolls her eyes] I'm not interested.' My mom said, 'Like, no, pads, real women's professional football. Everything is absolutely the same except for the size of the ball.' We use a smaller ball because women's hands are smaller.
I looked into it. I went to try out. I had to go all the way to Daytona Beach to try out, which in the New England area would probably be crossing a couple of states, but was still in Florida.
Q: It's not like going from Bennington to Rutland.
Guttmann: That's right. I made the team, and the rest is history.
Q: So you use a small ball, more like a Tom Brady ball?
Guttmann: We use the deflated ball [laughs].
Q: How long did you play?
Guttmann: I played for Orlando for three years. One year, I was injured, and I was functioning as their team doctor, as a perk for them.
My first year, my third game, I got sacked, blind-sided. And I dislocated my right hip.
I recovered. It took me nine months to get back to running or even walking without some sort of assistance.
And I got back to it and played my third season. I broke the [TD throwing] record and said, 'OK, it's time to continue to be a doctor because the bills are piling up.'
Q: You said you functioned as the team doctor during your recovery, but you also got to function as a patient of someone in your field during that time.
Guttmann: That's right.
Q: How did that experience inform you going forward as a physician?
Guttmann: I think more than anything it allowed me to empathize as an athlete, as an injured athlete, as an impatient athlete and as an athlete who thought that I could beat the curve.
Because it's actually one of the things that I struggle with the most even now with my athletes. They think they can beat the curve.
Q: When you say someone it's going to take six months, they think they can do it in four.
Guttmann: That's right. And athletes are some of my favorite patients because of this, but they're actually some of my most dangerous patients because they go and do too much too soon and get reinjured.
I always try to tell them: There is nothing you can do to make this better sooner. There is a whole lot you can do to make it worse. But there is nothing you can do to make it better.
Your tissues, your bones just need this time to heal, no matter what you do under this great blue sky. It just needs that time to heal.
It's a struggle for them, I get it. They feel better, and they think they can do it. And, unfortunately, you just can't defeat nature.
Q: And even knowing what you knew, you still had those impulses as an athlete?
Guttmann: Of course [laughs]. I thought I would be back in three months, and I was still ambulating with crutches, and it was insane to me. I thought, 'How is this possible?'
You learn a lot.
And I think also as an athlete, when I do get folks who are like, 'I'm a pitcher.' I'll say, 'Are you right-handed or left-handed?' It helps me with their mechanism of injury because I've played all those sports. I know that if they're a right-handed pitcher, their left leg is the lead foot off the mound. I kind of understand their mechanism of injury.
I understand when they say, 'I was taking this kind of jump,' or 'I was doing this type of sport,' I understand exactly what they were doing.
Q: What other sports did you play?
Guttmann: I played volleyball, basketball and softball in high school. I'm actually getting inducted into the Hall of Fame this weekend. I'm flying in for that.
I was all-Dade County, Athlete of the Year. And Dade County is a big county, so I'm proud of that. But it was long ago.
Q: Congratulations, what high school?
Guttmann: Our Lady of Lourdes Academy.
My wanting to be a sports medicine physician happened early on — before my schooling, before my injuries.
Q: Given your love of sports, it seems like a natural. Did you always want to be a physician and knew when you got there that this would be the specialty?
Guttmann: I think that evolved with my knowledge of certain specialties. At first, I wanted to be a trainer, and then I wanted to be a therapist. Then, I was like, 'No, no. It's a physician.' This was before any of my schooling, even. Once I was in school, I already knew I wanted to be a physician, which is why I decided not to play college ball.
Q: Because of the time demand.
Guttmann: I'm not that talented. I couldn't do both. I knew what it entailed to dedicate yourself to college athletics. Unfortunately, it entailed a lot of hard work on my part to get the grades I needed to pursue medicine. I couldn't do both. Some people can, but I knew I had to choose.
Q: Well, it worked out.
Q: And you got to play pro sports on the side, which most college athletes don't get to do.
Guttmann: It was a great experience. We got to travel to different states and meet other women who I am still friendly with. They're now coaching the teams, and, as you know, the NFL is now accepting women coaches. I think that is phenomenal.
The only regret I have is that I'm not younger.
Q: That you're not coming up in a time when there are more opportunities.
Guttmann: I may have pursued that path [laughs]. That's how much I love the sport.
Q: You've mentioned several times your love of football, and I understand the difference between a sports medicine specialty and neurology, but youth football right now is the subject of some controversy. You may have seen in Massachusetts there's a bill in the legislature to ban tackle football until the eighth grade. As a former and as a physician, do you think about those issues.
Guttmann: Of course, of course.
With women's football, I think that the talent would be much greater if we started sooner. Because when we started, we had to learn proper tackling techniques. We were never brought up with good tackling techniques as a female because it was never heard of to be playing women's professional football. It was never offered when we were younger, in elementary school or as a traveling team.
Boys are [taught technique]. It's offered at a young age.
I think women were at a disadvantage when it came to technique, per se. But now they're learning the techniques.
Your question is probably in reference to concussions.
Guttmann: Concussions and head injuries, we now know that is a serious issue, not just with football but any contact sport. Rugby actually has some of the highest concussion rates, as does soccer and some of these other sports. The legislators are trying to change the rules to keep our kids safe. And I get that.
And I think that there's always pros and cons to every rule. If you stop the tackle football until they're older, then I think that as they get older and insist on continuing to play, you've deprived them more of good tackling skills.
At the end of the day, when you know how to tackle properly — with your head up — this can prevent a lot of those injuries that we're trying to prevent by taking this away.
The best thing with concussions is to talk to your kids and let them know what the signs and symptoms of concussions are, so they're honest with you and actually tell you when they have concussions.
I find many times when you have a kid who suffers from a concussion, it's usually not the first time, and the parents are usually unaware. And it's the multiple-concussion athletes who fair the worst. It takes longer to recover. They get headaches for a prolonged period of time.
Even in the professional sports world, we know because of the diagnostic imaging and research they're doing that this can have lifelong consequences.
It's a controversial topic.
At the end of the day, I think that whatever side you favor, knowledge is power. The more you know and the more you teach your kid and your coaches — not just the kids, but the coaches and the parents — as to what the signs and symptoms are and it's not about the 'W,' it's about having fun and teaching your kid safety … I think we'll be more aware of, 'That kid looks like he got his bell rung. We need to take him out.'
Unfortunately, lots of parents think their kid is their 401k, and the potential of that happening is really, really, really almost non-existent. It's tough.
Q: On to happier thoughts ... You're going south this weekend, and everyone up here will be envious of that. Is this the time of year that the women's league is playing? Will you have a chance to see your old team?
Guttmann: They're starting tryouts and all that good stuff.
I won't see them this time. One came up to visit me maybe three weeks ago.
Q: Do you get to any games as a fan when you're down there?
Guttmann: Yeah, definitely. I try to go to as many as I can to support the league.
I think they're just coming out now with the WNFL channel this season. It's been at least 30 years women have been playing. It's about time.
As with all women's sports, it suffers from lack of support and lack of advertising and lack of media coverage. They struggle with that, but they continue, and they're thriving.
Like I said, now with women going into NFL coaching positions, I think it's bringing more limelight to it.
There are probably over 50 teams. There are two or three different leagues, which I think is a problem. You really have to consolidate. But everyone is trying to make their league the one league, they're still having these internal struggles.
I think if there was truly one league, this would be better for the league.
Q: Are they heading toward a model like the WNBA/NBA partnership?
Guttmann: That's what they're trying to do now, if they haven't already, is align with the NFL.
Tags: medical, pediatrics, Q&A, sports medicine, SVMC,
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