You could say this doctor makes house calls — to spacious dwellings with very large yards. Specifically, football stadiums. Dr. James R. Andrews, MD, an orthopedic surgeon with Alabama Sports Medicine & Orthopaedic Center, is senior orthopedic consultant for the Washington Redskins, co-medical director for Auburn University's athletic programs, senior orthopedic consultant for the University of Alabama football program, as well as for seven other universities and colleges in Alabama — oh, and one high school. During football season, he flies from one stadium to the next, depending on the day of the week. His practice doesn't begin on Friday night and end on Sunday, either; Andrews also attends team scrimmages. "On Wednesday nights, we're at Auburn during scrimmage," he says, "after which we check the players. Late Tuesday afternoons we travel to Tuscaloosa and do the same thing for Alabama." If you think that's a hectic travel schedule, consider that on Saturdays during football season, Andrews flies back and forth between wherever Auburn and Alabama are playing in order to cover both games. "It's a bit of a problem when their games overlap," he says. "Then, we're really flying all over the place." He also attends all Redskins games during the season, so he's in a unique position to see football played firsthand at all skill levels and intensity. "I've seen injuries associated with high school football all the way through the pros," he notes. "Injuries intensify in the professional ranks because the players are bigger and stronger and they're hitting harder and running faster. So when they do get hurt, it's with higher energy and greater impact." Covering athletics means that if a player is hurt on the field, the orthopedic team has to evaluate and attend the injury, make recommendations about treatment, and determine when the player will be able to play again. Even if there are no injuries during games, the medical team checks players for bumps and bruises, and they follow-up with trainers about care at the end of play. The types of football injuries sustained by players haven't changed much over the years, but Andrews says that changes in game rules have helped reduce some of the more serious injuries. For instance, players are no longer allowed to execute potentially debilitating "crack-back" blocks, which are blocks below the waist by players in motion toward the ball at the snap. "Of course football is a collision sport, so you're not going to prevent every injury," he says. "But we once saw many more severe knee injuries than we see today. The most common injury now is the isolated anterior cruciate ligament — the so called ACL knee injury." With the recent start of the fall football season, Andrews and his team have been busy putting players back together. On just one day of one week, he repaired a dislocated shoulder, multiple ligament injuries of the knee, four ACLs, an elbow injury, and performed two so-called Tommy Johns procedures, which is a ligament graft for throwing a ligament in the elbow. "In a Tommy Johns, you're using tendon graft from the wrist to replace the ligament on the elbow," he explains. "For ACL injuries you use the central portion of the patella tendon — the kneecap tendon — to reconstruct an ACL in the knee." Even though he says they have their place in orthopedic surgeries, Andrews says he's not a big fan of "cadaver grafts." "I elect not use these types of grafts on younger athletes," he says. "I worry about their longevity, so I prefer to use patients' own tissues." When it comes to preparing athletes for performance, Andrews advises proper conditioning and staying in shape all year round. "Football's a year-round sport, basically," he says. "And as such, it requires staying in shape and maintaining good flexibility regardless of the sports season, in order to prevent players from turning minor injuries into major ones, if they do get hurt. That's why treatment for minor injuries is so important. Checking minor injuries and working with trainers to get these kids prepared for the next battle is a large part of our work during the week." Something as common as sprained ankles can cause real problems further down the line if they're not treated properly. "If a kid tries to play on a sprained ankle," says Andrews, "he might find that he can't change directions well and can't protect himself properly — then he gets his knee blown out or turns a minor sprain into a major sprain, or it becomes a fractured ankle. Putting players back on the field too soon means injuries can quickly be compounded." Andrews points out that the entire Alabama Sports Medicine team is involved in the athletics programs of the nine colleges they cover. He works with Lyle Cain, MD, at Alabama and with his senior partner, Larry Lemac, MD, at Auburn. Another partner, Jeffrey Dugas, MD, helps him at Troy State. "We also have fellows doing one-year fellowships with us once they complete their formal training in orthopedics," he says. "Currently, we have nine fellows training via our American Sports Medicine Institute, which is our educational and research arm." Needless to say, with his long and extensive career in sports medicine, Andrews has athletes the world over coming to him for treatment — some of whom are household names among sports enthusiasts. For instance, last year, he performed shoulder surgery on Drew Brees, quarterback for the New Orleans Saints, and he repaired a multiple ligament injury of the knee on Miami Dolphins quarterback Daunte Culpepper. A former pole vaulter, himself, Andrews has operated on four of the top six pole vaulters in the world during the past three years, including the American record holder. He's also witnessed some awesome college football games, such as last year when Alabama beat archrival Tennessee for the first time in 10 years and Auburn went undefeated and won the Sugar Bowl. Sports medicine has its own role to play in any team's winning season.