Originally published in TrailblazeHERS in Sports, Issue 4 | June 30, 2026
Anya Dalal
Dr. Tom Hackett has operated on some of the most decorated athletes in the world. An orthopedic surgeon and head team physician for the U.S. Ski & Snowboard Team, he treats NHL players, professional soccer players, and Olympic skier Lindsey Vonn. Yet, when asked about the biggest gap in sports medicine for female athletes today, his answer has nothing to do with surgery.
“I would rather create initiatives that put me out of business,” Hackett said. “The best way to prevent these surgeries, which then lead to sometimes long-term problems, is to prevent the injury in the first place.”
For female athletes in particular, Hackett says prevention is crucial. He describes ACL tears as “kind of an epidemic,” especially amongst female soccer players. According to Hackett, and supported by much of the existing literature, female athletes often have different risk factors and muscle activation patterns compared to men, “so balancing out those muscle interactions is really critical, and that has to happen all season long, not just before the season starts.”
The common mistake, he believes, is treating strengthening as a pre-season box to check rather than a commitment an athlete makes throughout the year. “A lot of athletes just kind of grind on strengthening before the season starts, and then once they start playing, they’re tired and exhausted, and they have school and other things to do, and so the strengthening and conditioning kind of falls off.” Fatigue, he adds, is a huge injury risk: “There's definitely a correlation between fatigue, playing multiple days in a row, and then having an injury, because you don’t have the necessary stamina or you’re playing through fatigue.”
Still, Hackett is no stranger to the pressure athletes face to compete through pain, especially at the highest levels. Working with athletes like Lindsey Vonn, he is aware of how complicated competing can become when athletes are facing injuries. “I try to really bridge that gap between having respect for their short-term goals, which oftentimes have significant rewards in the long term,” he said.
At the same time, he is careful to weigh the cost of those decisions and to be mindful of the risks associated with certain activities. “It’s a real kind of gray area that we try to balance on an individual basis between identifying what’s a realistic risk and what’s one that is probably unrealistic, or overly burdensome on your future health.”
However, even when an injury does occur, Hackett argues that recovery is as much a mental process as it is a physical one. “The biggest component of the rehab process is patience,” he said. “You have to have patience that even when you feel good, you might not be ready yet.”
Hackett is also a strong advocate for integrating sports psychology into rehab programs, something that is surprisingly uncommon across the field of sports medicine. “It's not just about how many squats you can do, or what your range of motion is, or how much you can bench press… You have to have that clarity on your mental component to wellness and to sport readiness, and that comes from bringing in somebody else that can help with that particular subspecialty…making sure that you're mentally prepared,” he said.
Hackett emphasizes that confidence only comes through experience and taking safe risks: “Sometimes it takes the first wipeout or the first hit you take to realize, ‘Okay, I'm okay, I just got whacked, and I fell, and I'm going to be okay, my knee is fine.’” He believes rebuilding confidence requires a combination of grit, patience, mental toughness, and support from both medical professionals and mental health specialists. The other key component, he says, is the “surgeon instilling confidence in the athlete that the thing that they had worked on is good.” Ultimately, Hackett sees confidence as something that is rebuilt through experience and by taking safe risks, not only by meeting injury-specific medical benchmarks.
For young female athletes navigating pressure from coaches, parents, and their own goals, Hackett’s message ultimately comes down to empowerment and self-advocacy. “It’s very important for younger, especially adolescent athletes, to develop a sense of autonomy and empowerment to be able to say, ‘No, I don’t want to do this game, I don’t feel good.’” He encourages young athletes to recognize when the rewards from competing no longer outweigh the risk of playing through pain, which can lead to overuse injuries and potentially progress to more serious traumatic injuries.
Image Credit: https://www.usatoday.com/story/sports/olympics/2026/01/26/lindsey-vonn-medical-team-new-ad-campaign/88291877007/