Dr Paul Marks is Clinical Director at Imaging Associates Box Hill and an expert sports and spinal radiologist. Here, Dr Marks talks about the introduction, use and importance of game day imaging in the AFL, and its contribution to match success and improved player safety and wellbeing.
The Start:
In 2006, the Hawthorn Football Club was young and hungry for success. Their club President, Mr Jeff Kennett, had a bold vision called "5, 2, 50". The aim was to claim two premierships and fifty thousand members in five years. The club had a renewed medical team headed by Dr Peter Baquie, a quietly spoken and extremely experienced sports physician. I called Dr Baquie and introduced myself as a junior radiologist with a passion for sports medical imaging and treatment. Dr Baquie opened the door for me and quickly I became the main radiologist used by the club.
The Success:
In 2008, the club was beginning to see on field success with a raw and highly talented team. The season was long and bruising and the young bodies accumulated many niggles. The team qualified for the finals. Mr Kennett's dream was within reach.
I could see that Dr Baquie would have his hands full during the final series with so many sore players. I offered my services as a game day radiologist. This had not been done before in AFL history. We had to jump through some hurdles convincing the Hawthorn executive and the MCC that this would not impact negatively on the game day personnel and ground facilities. Thankfully, they gave us the nod.
In 2008, the ultrasound units we used were the size of a small fridge. To get the unit to the games, we hired a maxi-taxi. The team had an amazing final series, making it all the way to the Grand Final. My expertise lay in performing accurate delivery of local anaesthetic using ultrasound to guide me. My role on Grand Final day was to support Dr Baquie with rapid diagnosis and treatment of the players. We had our hands full that day. The team were underdogs, playing Geelong who were at the peak of their powers. The Hawks unexpectedly had the lead at half time. I missed most of the third quarter desperately trying to assist a player with a badly injured ankle. I arrived back on the bench at the start of the final term to watch the young team claim victory. It was an emotional day for all concerned.
The Safety and Support:
The team's success saw the Hawks embrace game day radiology in the years to follow. We could see that having an ultrasound unit and an experienced radiologist could greatly assist the medical team and provide improved safety for the players should they experience a significant internal injury.
On occasion I have travelled around Australia with the team, although most of the support was for domestic games in Melbourne. Dr Chris Holden, another radiologist in our group and now Chairman of Imaging Associates, soon joined me. Together we were there for the successful three-peat in 2013-15.
Over time, ultrasound units have reduced considerably in size. Today we use a tablet style unit with two probes that gather the information. One is for soft tissue injuries and the other for internal injuries. With the high-speed nature of the game the abdominal probe in experienced hands affords a level of comfort to the club.
On occasion, we have helped triage players who have been injured. With a normal scan and a reassuring examination by the club doctor, the player can be monitored at home. One memorable and frightening post-game ultrasound comes to mind. I was asked to drain a troublesome muscle cork in one of the player's lower abdominal muscles. The area of bleeding just kept refilling and an arterial injury was seen. The player was transferred to an Emergency Department where the arterial bleed was treated. Surprisingly, the player didn't miss a game.
The Future:
Imaging Associates' reputation for providing high end sports imaging and treatment has cemented a strong relationship with the Carlton Football Club. Together, we will be opening a diagnostic imaging facility at IKON park in 2025. Dr Mark Rassie, a passionate and talented radiologist, now performs game day ultrasound support for the Blues. Mark is a New Zealander and a sports tragic. He has rapidly become one of our leading sports radiologists. He provided key support for the Blues throughout their 2023 finals campaign and is convinced that the team can go further this year.
In recent times, Dr Johan Smalberger has become another AFL accredited radiologist. He will join our team this season.
In the cauldron of game day imaging, our skills are heavily tested. It is a raw and invigorating environment where there is no place to hide. Players, coaches and the medical team put everything on the line in sometimes difficult circumstances. We volunteer our time freely to support them in the hope that all players are afforded the highest level of care and safety.
Dr Paul Marks
Clinical Director
Imaging Associates Box Hill
Key Facts:
The story of the development of game day medical imaging in the AFL and its contribution to match success and improved player safety and well-being: From its inception and Jeff Kennett's "5, 2. 50" vision at Hawthorn Football Clubs with head of medical Dr Peter Bacquie through to current game-day imaging with Carlton Football Club.
About us:
Imaging Associates is a doctor owned and run, leading provider of medical imaging solutions in Victoria and Wagga Wagga, NSW. We offer a comprehensive range of diagnostic and interventional radiology services, with a focus on quality, expert diagnosis, fast results and compassionate care. Imaging Associates has extensive experience in the imaging of elite athletes and are seen as leaders in the field of sports, spinal and pain management. Our mission is to improve patient outcomes and support healthcare providers with advanced imaging technology and expertise.
