NASCAR medicine: in the fast lane with PA Bill Heisel

By Nichele Hoskins

It’s race day at Talladega and temperatures are in the mid-80s, surprisingly warm for fall. Bill Heisel, PA-C, stays hydrated and keeps up a snappy pace alongside pit road.

Like the NASCAR fans, drivers and pit crews, he’s swept up in the Chase for the NASCAR Sprint Cup, which is essentially the playoffs of stock car racing. And since, next to football, NASCAR is the most popular spectator sport in the U.S., this is a big deal—the race results will determine which eight cars will move on to the Eliminator Round.

So Heisel, wearing comfortable shoes and a red polo-style shirt embroidered with an OrthoCarolina Motorsports logo, keeps moving from pit box to pit box, looking for a thumbs-up or a wave-in to check on an injured pit crew member.

Heisel’s an important contributor to the race scene. But he doesn’t spend Sunday afternoon driving stock cars at nearly 200 miles an hour. He’s not one of the guys jacking up cars, changing tires and pumping fuel in the graceful, muscular car-eography that animates pit road. But he is the guy who takes care of the guys who take care of the cars.

A PA in orthopaedic surgery with a background in sports medicine, he was working for OrthoCarolina in Charlotte, N.C., when Ricky Hendrick, son of Hendrick Motorsports owner Rick Hendrick, crashed in a race in Las Vegas and injured his shoulder. Heisel assisted in surgery and later collaborated with NASCAR on altering the design of the seat inside the car to prevent similar injuries. OrthoCarolina is the official provider of healthcare to the Carolina Panthers, the Charlotte Knights, the Chicago White Sox’ Triple-A team, and about two-thirds of NASCAR’s racing teams, including Joe Gibbs Racing, Hendrick Motorsports, Stewart Haas Racing, Roush Fenway Racing and Richard Petty Motorsports.

And a good part of that is due to Heisel.

He came up with the idea to start OrthoCarolina Motorsports a little over a decade ago, after he proposed becoming the medical liaison between OrthoCarolina and the NASCAR nurses who attend Camping World Truck Series, Xfinity and top-level Sprint Cup events.

Heisel has run the growing, profitable specialty service line ever since.

“I didn’t start off with a passion for racing,” he said. “I started off with the idea that you can take sports medicine principles usually applied to stick-and-ball sports and apply them to caring for pit crews and race teams. I went from knowing little to nothing about NASCAR to basically drinking from a fire hydrant and learning a lot about the engineering, the positions and basically learning how to speak the language.”

In 2014 he went from spending 12 to 14 hours a day in other OrthoCarolina duties, then working with the pit crews after hours, to being available to the crews all day—every day.

The NASCAR season is the longest in all of sports and 38 racing weekends take a toll on everyone, from the drivers and coaches to the pit crews. Couple that with the fact that motorsports technology has evolved rapidly, and the physical demand it puts on pit crews and drivers has increased significantly.

The injuries Heisel sees among the NASCAR patient population would be familiar to anyone who specializes in orthopaedics or sports medicine. But with his generalist education as a PA, Heisel also does a fair amount of preventive and family medicine. “To maintain peak performance all season long, especially for our over-the-wall athletes, it is critical to have proper recovery and preventative care, as well as access to quick, efficient medical treatment,” said Michael Waltrip, founder of Michael Waltrip Racing (MWR) and a two-time Daytona 500 champion. “OrthoCarolina Motorsports and Bill Heisel have provided MWR the perfect solution.”

OrthoCarolina has proven itself to NASCAR. But “most importantly, they are trusted by our employees, which is what everyone needs when it comes to personalized care,” Waltrip added.

 

 

PA Bill Heisel doing rounds at Charlotte Motor Speedway
PA Bill Heisel doing rounds at Charlotte Motor Speedway in Concord, NC. (Photo credit / Christa L. Thomas)

The human factor

The green flag whips over Talladega Superspeedway. The cars take their first laps, rumbling deep and loud around the 2.66-mile oval. This is NASCAR’s longest track.

Stock car racing is a sport of highly visible technology and hardware, so it’s surprising how primal it is to feel the almost tectonic rumblings of the speeding cars move up from your feet to your gut. With these machines and their drivers in such prominent roles, pit crews could be easy to overlook, if there weren’t so amazing to watch and if doing their jobs well weren’t sometimes pivotal to the outcome of a race.

“The human element in racing is absolutely crucial,” Heisel said. “The average speed for a four-tire stop four years ago was 14 seconds. Now it’s in the low 11s or high 10s. We have to keep guys as healthy as we can. Human performance in pit crews buys positions on the track.”

The right crew can move a car up in the rankings while it’s standing still. It was in the 1990s that NASCAR teams began to embrace the idea that races aren’t won and lost on the racetrack alone. So they started moving away from training mechanics to pit the car on race day and began teaching athletes—football players, baseball players, wrestlers — to pit a car.

Here’s a scenario: You’re a front tire changer. At your fastest and most accurate, you can loosen five lug nuts in a single second; before one lug nut hits the floor, you’ve put a mean air-gun spin on the next. Your car has a slight lead in a pack of the 10 cars. The driver and several others in the top ten screech onto pit road for a four-tire change and fuel. You and the rest of the crew are ready.

Your adrenaline is pumping. You hop over the wall, executing the steps you and the rest of the crew have worked to perfect. But a few things go wrong: It takes the jack man an extra second to crank the car far enough off the ground for you to change the tire. Despite your training, you miss the fifth lug nut on the first tire. It slows your flow and the flow of the rest of the crew, costing the team about two seconds.

“If you were first, you could fall to 20th on the basis of a two-second mistake,” Heisel said. And if you were trailing, someone else’s pit road error could move you closer to the lead. It’s a personnel sport, even though they’re driving a car, said Donald D’Alessandro, MD, who practices in collaboration with Heisel at OrthoCarolina.

“It’s always interesting to think about how critical a second or a couple seconds is in the outcome of a race, and how precisely they have to do it,” D’Alessandro said. “There’s so much parity in the car themselves … that a lot of the difference in winning and losing a race comes down to the person behind the wheel, the coaching staff and the pit crew guys.”

Heisel and D’Alessandro have been friends and colleagues for 23 years. D’Alessandro , characterizes their working relationship as one of cooperation and mutual respect. “You think of a [PA] as assisting the physician. But essentially, I’m his backup,” D’Alessandro said. “He has earned everybody’s trust. He also knows he has my support.”

Heisel assists in some surgeries, many of which are scheduled in the brief off-season between November and February.

 

PA Bill Heisel examining injuries in pit crew members
PA Bill Heisel says the injuries he sees among pit crew members would be familiar to anyone who specializes in orthopaedics or sports medicine.(Photo credit / Christa L. Thomas)

 

 

 

 

The mayor of Pit Road

Each racing shop is a bit like its own ward or borough: proud, protective and insular by design and competitive necessity. There are no guards or gates, but folks are sensitive about the possibility of unauthorized images of the cars in various states of repair and revision getting out onto social media and into the wrong hands. Each shop is “very proprietary,” Heisel said.

But Heisel is one of the few people who can walk into Stewart-Haas Racing in the morning, Joe Gibbs Racing in the afternoon and several others in between—more evidence of the trust he’s earned. “Moving between shops this easily is pretty rare,” he said. But he He gets around easily among pit boxes on race day, too. Each box is the pit road command center for each car. Nearby, the haulers—massive trailers used to move tools, cars and other equipment from Charlotte to the racetrack du jour—serve as another communication center.

Each pit box has two levels: a viewing stand for crew, guests and families on the upper level and monitoring screens and tools below. The fire lane behind the pit boxes is where fans bearing “hot passes” can watch the race, and where crew members roll dollies back and forth, moving used tires and empty fuel tanks and bringing in fresh supplies. Between stops, a pit crew member hands out pairs of earplugs to fans nearby.

As part of his race-day rounds, Heisel walks up and down pit road chatting with pit crews. Before the race he gently palpates a tire carrier’s recovering wrist to test for pain. He steps up his pace after each pit stop, which is when most injuries happen. Once the cars pull away, he’ll catch the attention of a designated crew member in the pit, looking for a thumbs-up indicating that all’s well or a sign that someone needs medical attention.

At Talladega, he stops to talk to Mark Armstrong, a tire changer for BK Racing. He had been recovering from injuries to the latissimus dorsi and serratus anterior muscles of his upper back. As with all but the most serious injuries, Armstrong’s injuries had been managed with meds and intense physical therapy. “Two stops under his belt and no pain,” Heisel said.

(Click to enlarge)

 

PA Bill Heisel at end of a full day at Charlotte Motor Speedway
PA Bill Heisel at end of a full day at Charlotte Motor Speedway in Concord, NC. (Photo credit / Christa L. Thomas)

High-speed healthcare

The Monday morning after race day comes fast, too. Moments after the race ends, Heisel takes fast strides to get to his medical bag—a black, soft-sided carrier originally designed to carry fire suits. Inside, plastic containers with dividers hold bandages and meds. He and the rest of the team members sprint to get to a team plane, private but reportedly not glamorous, then fly back to Charlotte, arriving late that night or, in the case of West Coast races, early in the morning.

After a few hours of sleep Heisel makes Monday rounds at the race shops at Stewart-Haas Racing, Hendrick Motorsports, Joe Gibbs Motorsports, Roush Fenway and other team headquarters. He treats new injuries and attends to old ones that may have been aggravated.

Monday is recovery day for the pit crews, which can include stretching, therapy and even yoga. Those who need it get checked, diagnosed, treated or referred to specialists. Tuesday and Wednesday are spent reviewing tape, practicing and training. On Thursday the team flies to the speedway. There’s a day or two of practice, race prep and interaction with fans—then Sunday is race day.

Whatever day it is, Heisel is there to manage whatever health issues might slow down the pit crew. He sees plenty of hernias and kidney stones. “We get our fair share,” he said. “This is the kidney stone belt,” citing the South’s love for sweet tea and ice cream.

And because crews work, practice and travel in close quarters, a bad gut bug can spread fast.

“You can have a GI virus and it can spread very quickly through an airplane, airborne or from hand to mouth,” Heisel said. “These guys are walking down the same aisles, patting each other on the back. Hand sanitizers help, but they’re no match for three minutes at a sink with warm water, scrubbing.”

As team healthcare provider for some of the largest NASCAR teams, he also provides care to all their employees. Heisel is the healthcare point person for everyone from custodians to the drivers to team CEOs to the 3-year-old son of an accounting manager who fractures an arm during a weekend soccer game. He focuses on his orthopaedic specialty and can treat most general complaints, but refers to specialists when needed. “I draw the line at cardiac issues,” he said. “I don’t treat hypertension and heart murmurs in race shops.”

Joe Gibbs Racing, the first team OrthoCarolina Motorsports took on as a client, has about 250 employees, and another 350 dependents, Heisel said. Multiply that by six for each of teams the group works for, give or take, and that’ll give you an idea of the scope of his practice.

Heisel is always on call. Always.

The Friday before a fall Talladega race, he got a call from a driver who admitted to “doing something stupid.” He’d been riding on a parade float, yucking it up with fans, when he slipped and fell, aggravating the knee that had recently been operated on.

“Most of them have my cell phone number. If they have a problem, they’ll call. They know how to find me.”

 

 

 

 

 

 

 

Anatomy of a Nascar Pit Crew infographic
PA Bill Heisel walks Pit Road at Charlotte Motor Speedway in Concord, NC. (Photo credit / Christa L. Thomas)

The pit and the pendulum

In 2014, Stewart-Haas Racing made an unexpected move. The team swapped the pit crews of Kevin Harvick, who drives the #4 car, and Tony Stewart, who drives #14. The idea was to put the best crew together with the best driver in the building to increase the chances of winning.

Tire changer Ira Jo Hussey, a 19-year pit crew veteran, was one of the men who made the move to Harvick’s #4 car.

“Those guys (who moved to Tony Stewart’s crew) all got put together last year. We’ve been together 4½ years. It’s definitely an advantage,” Hussey said. The fastest a crew he’s been on has ever pit a car is 10.9 seconds, he said. “Usually it’s 11.2 or 11.8.”

Hussey went from high school, where he ran cross country and played football and basketball, to a pit crew. His goal had been to stay in the job for 20 years but despite the long, 38-week-long seasons with no time to fully recover, he feels optimistic, in large part because he feels healthy. “I think I can go another five or six years, depending on how well I take care of myself. Eventually I’m going to slow down and lose a step.”

It wasn’t too long ago that it was the physical wear and tear that would dictate when a pit crew member bowed out of the business. Now, with the help of the wrap-around care OCM provides, Hussey has choices.

Before packing himself up for a race in California, Heisel packed up uniforms for his daughter’s softball team; he’s a team coach.

“Now I’m thinking 25 years. If I hit 25 … I want to be around for those weekends when we’re going to (softball) tournaments,” he said. “Besides that, I don’t like flying.”

 

PA Bill Heisel walks Pit Road at Charlotte Motor Speedway

PA Bill Heisel has made OrthoCarolina the go-to medical provider for some of the top teams in NASCAR. (Photo credit / Stephanie Chesson Photography)

Moving the needle

After Kevin Harvick’s win and the end of the season there was celebration. Then for a few weeks Heisel pulled in his shingle to recover from the season, relax and spend time with his wife and daughter.

Although Heisel has worked with race shops for years, he’s only been working fulltime on  OrthoCarolina Motorsports since 2014. And being on call at all hours of the day “pisses my wife off to no end,” he said.

“I’ve missed some of my daughter’s events at her school. My family has sacrificed a lot to make this go.”

But Heisel hopes to spend more time with his family —hiring more staff to join his hard-working and talented team.

From racing, OrthoCarolina has had 1,700 paid office visits, handled by 57 different physicians and 25 PAs. “OrthoCarolina Motorsports is me doing a lot of work, but also a collective group, a company-wide initiative I spearhead,” Heisel said. “The success of the program is a direct reflection on those professionals.”

 

 

PA Bill Heisel

PA Bill Heisel examines a NASCAR pit crew member. Today’s pit crews are comprised of former college athletes.  (Photo credit / Stephanie Chesson Photography)