Abstract
The sports medicine community recently lost one of its most influential pioneers, Joseph S. Torg, MD, AOSSM Hall of Fame member and arguably the “Father of Sports Medicine.” Dr. Torg possessed fabled grit and determination that, coupled with his genius, propelled him to create a tsunami of positive change directed toward ensuring the safety of athletes.
Dr. Torg was born in Philadelphia, Pennsylvania, and attended Haverford College, where he excelled on the gridiron. He received both his medical and orthopaedic training at Temple University School of Medicine, where orthopaedic icons Howard H. Steel, MD, and John W. Lachman, MD, helped mold Dr. Torg into a brilliant clinician and surgeon. In 1972, Dr. Torg and Ted Quedenfeld, the head athletic trainer at Temple University, created the first academic center for sports medicine in the United States, which provided exemplary care to athletes and served as a foundation for prolific research. In 1978, Dr. Torg was recruited to establish the University of Pennsylvania Sports Medicine Center. Throughout his career, he served as a mentor to numerous fellows, residents, and students and served as team physician for most of the professional teams in Philadelphia.
Dr. Torg’s brilliant and inquisitive mind prompted him to relentlessly challenge existing paradigms regarding the care of injured athletes. He possessed exceptional self-assuredness, and once he solved a research question, nothing would deter him from bringing his thesis to fruition. His integrity was remarkable and he was passionate about any injustice, especially concerning avoidable injury.
His research findings were game changers and resulted in seismic shifts in the field of sports medicine. In conjunction with Ted Quedenfeld, Dr. Torg recognized that football shoe cleat designs created excessive levels of turf friction and potentiated catastrophic knee injuries. Their published groundbreaking research on the cleat-turf interface resulted in the transition to the modern cleat design. The number of knees spared devastating ligamentous damage from this work is incalculable.
In a landmark article in 1976, Dr. Torg described an examination to accurately diagnose anterior cruciate ligament (ACL) tears and called it the “Lachman test” to honor his mentor. This test has become the most cited examination tool in sports medicine and has empowered clinicians to accurately diagnose ACL tears in an expedient fashion with extraordinary sensitivity.
The hallmark of Dr. Torg’s storied career was his revelation that spear tackling, or tackling with the crown of the head, caused axial loading on the cervical spine, which sometimes led to quadriplegia. He overcame resistance from the National Collegiate Athletic Association to change the rules, and the subsequent ban on spear tackling reduced the rate of quadriplegia in football from an average of 30 cases per year to 5 to 6 cases per year.
Through his creation of the National Football Head and Neck Registry, Dr. Torg described cervical cord neuropraxia (CCN) as a distinct benign entity, which does not preclude the return to football. He recognized the relationship of CCN with cervical spinal stenosis and the risk of recurrence based on the degree of stenosis. His recommended use of the cowboy collar reduced the risk of extension burners, protecting countless neurons from repetitive trauma. In addition, he published comprehensive criteria for the safe return to sports after cervical spine injury. Dr. Torg challenged the existing paradigm of delayed reduction of traumatic unilateral and bilateral facet dislocations. He passionately advocated for immediate reduction and stabilization of these injuries, enhancing the chances of neurologic recovery.
With his unparalleled insight, Dr. Torg was the first to recognize that tarsal navicular and fifth metatarsal stress fractures could be problematic and required early diagnosis and nonweightbearing to allow for healing. He published the first comprehensive article demonstrating that most isolated posterior cruciate ligament injuries can be treated nonoperatively and crusaded against recommendations for surgery for this condition. He contributed to the understanding of the noncontact ACL injury mechanism as an axial compression force. Lastly, he developed the first classification scheme for concussions, which was the foundation for more contemporary characterizations of this common sports affliction.
Dr. Torg received numerous accolades throughout his career, to include distinguished alumni awards at Haverford College and Temple University School of Medicine as well as the Kappa Delta and Nicolas Andry awards.
In addition to his prolific research, Dr. Torg was a lifelong proponent of helping the disadvantaged, supporting equal rights, and protecting the environment. Throughout his career, he provided free care to Philadelphia scholastic athletes and was especially attentive to the underserved. He spent countless hours devoting charity care to patients at Temple University, St. Christopher’s Hospital for Children, and the Shriner’s Hospital. In 1974, he served as the critical expert witness in legal proceedings that resulted in girls’ being allowed to participate in Little League Baseball. In 1997, Dr. Torg and his wife preserved 21 acres of threatened wetlands (Joe Torg Wetlands) on Long Beach Island in New Jersey. He established the John Lachman Research Society in 2001 to honor his mentor, promote resident research, and encourage integrity and ethics. In the autumn of his career, Dr. Torg and his wife funded several scholarships for academically talented youth who have financial needs.
Dr. Torg was a man of traditional values and cherished his wife of 63 years, Barbara, and their 3 children: Joseph (Kathy), Betsy (Mark), and Jay (Cynthia), as well as 7 grandchildren. He was a proud veteran and served as a captain in the US Army from 1962 to 1964.
Dr. Torg’s brilliant insight, tireless work, determination, and courage of his convictions, regardless of the fallout, all distinguished him. We have revered Dr. Torg and his portrayal of the power of indomitable will. Dr. Torg was a true renaissance man who transformed our beloved vocation of sports medicine into the modern era, all in the name of benevolence and defending the vulnerable. For all who have engaged in a contact sport, they must humbly acknowledge that they likely have been spared from potential catastrophic cervical or knee injury thanks to the genius of Dr. Torg.
Our hero, requiescat in pace.