The team behind a healthy season

The sports medicine team has kept student-athletes healthy and safe throughout the pandemic, resulting in the busiest spring sports season ever at Carolina.

Mario Ciocca sits in the stands of a baseball stadium.
Dr. Mario Ciocca, director of sports medicine, attends a Tar Heel baseball game against the Carolina Coastal Chanticleers at Boshamer Stadium. (Jon Gardiner/UNC-Chapel Hill)

Bottom of the fifth inning, Carolina trailing Miami 4-1 and a Tar Heel batter belts the baseball to centerfield. The Miami fielder leaps for the catch, crashes into the protective padding, then crumples to the ground still holding his glove above his head. Is it a catch?

The umpires say yes. The Carolina coach isn’t so sure. He asks for a review and stands on the grass at the edge of the field to discuss the call with two of the umpires. All three are wearing masks.

So are the fans in Boshamer Stadium, except the ones currently eating or drinking. The game is technically sold out, but at only 20% of the stadium’s capacity. That’s about 850 people, not counting the cardboard cutout fans behind home plate.

This is college baseball in a pandemic. And while it’s very different from baseball in a normal year, no one is complaining. Last year at this time, baseball and all other collegiate spring sports were canceled as a response to the spread of the COVID-19 virus.

This spring, they’re all back and so are the fall sports that were postponed till the spring. That means 27 of 28 sports teams at Carolina have been in competition this spring, all 28 if you count the spring football scrimmage. That makes spring 2021 the busiest sports season ever, with at least a half-dozen expected to vie for national championships. The football team went to a major bowl game for the first time since 1950. And Carolina didn’t have to pull out of a single competition due to COVID-19.

But the team that’s worked hardest to make all this happen isn’t one of these 28. It’s Carolina’s sports medicine team.

“Over the last year, it’s been all hands on deck,” said Dwight Hollier, senior associate athletic director for student-athlete health, well-being and program outreach. “It’s been a real team effort. They’ve done amazing work.”

Independent medical model

At Carolina, the sports medicine staff is part of Campus Health and provides care to all students who are physically active as well as serving as team physicians for the athletics department.

“It’s called an independent medical model and it’s what the NCAA recommends,” explained Dr. Mario Ciocca, director of sports medicine. “There’s a perceived conflict of interest if it looks like coaches are pressuring you and could fire you if they don’t like what you’re doing. You want the people making medical decisions reporting to medical people.”

When the pandemic hit, this collaborative model became particularly important as serious medical decisions were being made daily that affected not only student-athletes but team sports in general. “Last spring, we were wondering, ‘Can we get students back on campus? Can we have a fall season? What are the risks?’” recalled Ciocca, who was also part of the ACC Medical Advisory Group that met weekly to share information on the impact of COVID-19 on ACC campuses and intercollegiate athletics. Advice and practices changed as medical experts learned more about the virus and developed ways to deal with it.

For example, Carolina’s commitment to develop its own on-campus testing resources was a real gamechanger for athletics. In the early days of testing, when tests were sent to an off-site laboratory, sports medicine staff might not know the results until the next week. That window increased the risk of a team member not showing symptoms spreading the virus unwittingly to teammates. Now they see results within 48 hours and test student-athletes two to three times a week, depending on the sport. “The University lab has been great. We’re lucky to have turnaround times that are so fast,” Ciocca said.

Variations by season and sport

Last summer, the Atlantic Coast Conference decided to go ahead with the fall season in football and fall Olympic sports such as cross country, volleyball, field hockey and men’s and women’s soccer. But not all conferences made the same decision, so the NCAA postponed championships for the Olympic sports till this spring.

The NCAA doesn’t govern the football national championship, so that was held as scheduled. The NCAA canceled the 2020 basketball tournaments but went ahead with the 2021 season and held the 2021 tournaments in “bubbles” in Indianapolis (men’s) and San Antonio (women’s). Other spring sports that had been canceled in 2020 went on largely as usual in 2021.

Within those parameters, Carolina also played on, even though the two major revenue-generating sports (football and men’s basketball) played in mostly empty stadiums because of COVID-19 restrictions. The dip in revenue caused athletics staff to work under furlough conditions, while sports medicine staff worked diligently over the summer to prep for the fall.

“We’ve had to redo everything we’ve done. Every operation has been changed,” said Scott Oliaro, associate director of sports medicine.

Athletic trainer Terri Jo Rucinski and REMINGTON, the team rehabilitative facility dog

Athletic trainer Terri Jo Rucinski and REMINGTON, the team rehabilitative facility dog, are part of the sports medicine team that is keeping Carolina student-athletes healthy and safe during the pandemic. (Jon Gardiner/UNC-Chapel Hill)

Teams met outside instead of in. They traveled on more buses so players could sit farther apart. Student-athletes picked up box lunches instead pf eating together in a dining hall.

“We have training room appointments now to limit the number of people in the room. Each athlete has their own water bottle with their name on it. We take temperatures. If anyone’s feeling even a little congested, we hold them out and check their contacts. The athletic trainers are wearing masks and wearing gloves. And now most of the athletes on most of the teams are vaccinated,” Oliaro said.

Certain adjustments had to be made according to how each sport is played and where. Indoor and contact sports are generally more risky than outdoor and noncontact sports. But each sport presented its own challenges.

Some sports — golf, tennis — were considered fairly low risk. But track and fencing events — even though they are largely non-contact, individual competitions — are played in meets that bring athletes from several different colleges to the same place at the same time, increasing the risk of transmission.

Volleyball occupied a similar gray area. Not really a contact sport, it does have team members playing close together and indoors. So the volleyball team became the only one to wear masks while competing.

Kaya Merkler, shown here in a game against Notre Dame, and the rest of the Tar Heel volleyball team wore masks during competition.

Kaya Merkler, shown here in a game against Notre Dame, and the rest of the Tar Heel volleyball team wore masks during competition. (Jeffrey Camarati, UNC Athletics)

In contact sports, where the protocols can’t be followed during actual competition, sports medicine staff made sure they were enforced everywhere else — in practice, team meetings, weight rooms, during meals and while traveling — and made other adjustments.

For example, since wrestlers can’t wrestle 6 feet apart or while wearing masks, the sports medicine staff was particularly vigilant with testing, requiring the student-athletes to be tested three times a week as well as within 48-hours before and after each match.

Sometimes technology came to the rescue. The men’s and women’s basketball teams in the ACC, for example, had wearable technology to record data about game performance. With some adjustments, the same technology could be used to track when a player came within 6 feet of another. In practice, a warning buzzer would go off. The buzzer was disabled during games, but the data could be tracked afterward in case a player turned out to be positive and a risk for transmitting the virus. Without the technology, staff would have scanned video for hours to track the movements of a positive player.

Sport psychology

COVID-19 posed challenges not only to physical health but also mental health, and the two sport psychologists on staff found themselves addressing much more than the usual performance-related issues.

“We’ve been incredibly busy on the mental health side,” said sport psychologist Jeni Shannon. “Anxiety, depression, eating disorders, stress, isolation. We’ve worked really hard to meet the needs as best we can.”

In general, they have worked with the student-athletes on managing uncertainty and dealing with isolation. They met with every team as they transitioned back to campus in the fall and afterward held weekly sessions in person with many of the teams and virtually with individuals. They have talked with coaches and athletic trainers about how to spot students who are struggling.

But overall, she thinks many student-athletes are coping surprisingly well. “I have been so impressed with their resilience and adaptability,” Shannon said. “They’re doing the best they can with this situation.”

Hollier said the same about the whole team behind maintaining the student-athletes’ physical and mental health. “In this process, the effort has been to keep the student-athletes safe and enable them to do something they love,” he said. “We’ve done everything we could to make that happen.”

Ciocca agreed. “There was constant work going on. A lot of us didn’t take vacation,” he said. “Was it worth it? Yes, it was worth it, to give that opportunity to our student-athletes.”