N.F.L. Injury Analysis as Fast as You Can Say Ouch

The collision, in November, looked even worse in slow motion. New England Patriots running back Sony Michel had been hit so hard by the Jets’ defense that his back seemed to bend like a taco shell. He limped off the field.

But as doomsday proclamations from Patriots fans lit up social media, one Twitter account offered a cooler assessment. David J. Chao, better known as @ProFootballDoc, speculated that Michel was probably O.K.

“Hyperextension back injuries look bad and can cause pain but rarely lead to significant injury,” wrote Chao, who has an orthopedics practice. “Expect to see #SonyMichel return.”

Indeed, Michel was back on the field a few minutes later.

Chao, a former team doctor for the San Diego Chargers, was nowhere near the play, which took place at MetLife Stadium in East Rutherford, N.J. But that hardly seemed to matter. Over the last five years, he has amassed more than 112,000 followers on Twitter with a knack for immediately assessing N.F.L. injuries from his couch in La Jolla, Calif.

As a result, Chao has become a go-to expert for fans and fantasy players who want all the gory details of the game as quickly as they can get them.

He may also have become an asset for N.F.L. gamblers, particularly those looking to make in-game wagers and thus eager to find any sort of edge.

Having medical experts weigh in on prominent sports injuries is hardly new, of course. But the advent of social media has helped propel Chao and others toward another level of influence. They are, in effect, armchair doctors.

Chao has become prominent enough that people now routinely seek his advice on Twitter on how to heal faster from a torn rotator cuff or fix a balky knee. Another orthopedist, Mark Adickes, is employed by DirecTV to provide on-the-spot analysis of N.F.L. injuries on the Fantasy Zone channel.

Like Chao, Adickes has an N.F.L. background, having spent a half-dozen seasons as an offensive lineman for Kansas City and Washington.

There is also Jene Bramel, who has a background in pediatrics but has become another source for quick analysis of N.F.L. injuries while working from his home in western Ohio. He has nearly 38,000 followers on Twitter.

“I see it as an educational service,” Bramel said of his efforts. “Every week, there’s something a little bit different.’’

There are, however, dissenters. Medical assessments during N.F.L. games strike some health professionals as seriously misguided. After all, judgments are being offered on players by doctors who have not examined them.

Leigh Ann Curl, a team doctor for the Baltimore Ravens and president of the N.F.L. Physicians Society, said that although certain injuries were more easily discernible from afar, any such diagnosis was at best an educated guess.

“You have to realize when you’re making those assumptions based on such few pieces of the puzzle, there’s going to be a lot of times those assumptions can be very wrong,” she said.

In any case, Chao’s stature is growing. He recently started a podcast that runs during the week and he writes a column about N.F.L. injuries for The San Diego Union-Tribune, for which he is paid. He also has a role as a periodic injury analyst on SiriusXM, for which he is also paid.

Chao’s game-day insights may also be attracting people who make N.F.L. in-game wagers. Those bets reflect a point spread that shifts in reaction to what is taking place on the field, which would obviously include injuries to significant players.

This form of wagering, which accounts for 22 percent of sports bets worldwide, according to the bookmaker William Hill, is becoming increasingly popular among N.F.L. fans. If Europe’s sports betting habits are any indication, it will probably gain even more of a foothold as gambling on mobile phones continues to proliferate throughout the country.

Meanwhile, in the background of Chao’s Twitter posts is the fact that he has a checkered professional history. While his medical license is active in California and he continues to run a practice in San Diego, he has twice been placed on probation.

In 2012, he was reprimanded by the California medical board in connection with drunken-driving episodes. In 2014, he was put on probation by the board as a result of patient complaints. Two years later, he was again punished, this time for his lack of record-keeping in connection with the sleep medication Ambien, which Chao prescribed to the former Chargers linebacker Junior Seau before Seau committed suicide in 2012.

And in 2013, Chao was singled out by DeMaurice Smith, the head of the players’ union, who called for the Chargers to fire him.

Chao’s fellowship with the American Association of Orthopedic Surgeons remains suspended, and he has not been certified with the American Board of Orthopedic Surgery since his 2014 probation.

Asked about these issues, Chao defended his credibility as a doctor, and a number of Chargers players have come to his defense over the years. As for his growing Twitter presence, he maintains that his long experience on the sideline should establish him as a credible commentator. And he has become more savvy about the “gotcha” culture of social media.

For instance, when he spots an injury, he now typically says, “By video, it appears to me. …”

“I’ve adapted,” Chao said. “It’s making it clear that I’m not reporting from a source. Believe it if you want, but it’s my impression.”

Chao also acknowledges to his followers that his opinions are not always perfect. But he also frequently cites his accuracy percentage, which he says is above 90 percent since he started posting in 2013, not long after he stepped away from his post with the Chargers, a position he had held since 1997.

It was then that he started a Twitter account under a pseudonym, @ProFootballDoc, to talk about the injuries he was observing. At first, he said, he wanted his account to remain anonymous, but he eventually attached his real name to the feed.

“I certainly didn’t have a thought-out plan,’’ he said. “ I thought I’d try it for a few weeks. Very quickly, it caught on.”

Chao maintains he is no different from a former quarterback who can see plays unfold from the broadcast booth. He says his experience as a team doctor gives him insider knowledge without having insider information.

He also noted that as the Chargers’ doctor he would often rely on video replay to reverse engineer the nature of an injury. Indeed, since 2012, video monitors have been on each team’s sideline to help medical staff analyze injuries.

And those monitors, said Matt Matava, a former team doctor for the Rams, are an important tool.

“You can replay in slow motion to help decipher the injury,” he said. “It’s only a natural corollary that Dr. Chao and others like him are able to make an educated guess about what’s happened.’’

But video can also paint an incomplete or misleading picture. In a game between Washington and Philadelphia this month, Redskins quarterback Colt McCoy went down with what looked like a minor leg injury. “A good example of a leg contusion,’’ Chao posted. “Sore but will continue.”

McCoy continued to play, but not for long. An X-ray revealed he had fractured his fibula.

“I will take the mistake,” Chao later posted. “Video never perfect but clearly this is one of the errors, but note that I have not deleted the tweet.’’

Curl, the Ravens’ doctor and the president of the N.F.L. Physicians Society, said the group did not have guidelines addressing whether members should make public remarks about injuries they are not personally dealing with because such a policy never seemed necessary.

“Most of us, I think, would feel a little bit uncomfortable trying to weigh in,’’ Curl said. “And if you’re wrong, then it reflects poorly on yourself.”

One supporter of Chao’s commentary is Will Carroll, a journalist who has written three books about sports injuries. He applauds Chao and others who use their knowledge to try to inform the public.

“There’s a level at which it keeps teams honest,” Carroll said.

Matava is generally supportive, too. As long as the analysts are not second-guessing the work of the team doctors, he said, he does not have an issue with their online personas.

“I don’t have any ethical problem with what he’s doing,” he said, referring to Chao. “As long as he stays in his lane.’’

That is what Chao plans to do, watching and posting as players continue to be injured.

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