Margot Putukian, MD, FACSM, FAMSSM, is the chief medical officer of Major League Soccer, team physician for the US Soccer Women’s National Teams and the former director of athletic medicine and head team physician at Princeton University. She’s also a current committee member on the NFL’s General Medical Committee, a senior advisor for their Head, Neck & Spine Committee and a past member of the ACSM Board of Directors. Others may know her as one of the long-term executive committee members of the Team Physician Consensus Conference, or TPCC, documents.
Putukian got her start playing “all kinds of sports” in high school and went on to play four years of soccer as well as a year of lacrosse at Yale University, where she earned a BS in biology. She also played soccer on both the Massachusetts and Connecticut state teams.
The brief lacrosse stint was downstream of a partial but high-grade injury in her first collegiate soccer season. Fortunately, she didn’t need surgery. And after rehabbing, she decided to catch the spring athletic season by playing lacrosse:
“I tore my ACL my freshman year, and that was the reason I tried out for the lacrosse team,” Putukian says. “I wanted to continue to play at a high level.”
But as she neared the end of her undergraduate studies, she began thinking about what she might do with her biology degree. The rehab she’d performed after the ACL tear, along with the physicians she met during the treatment and recovery process, prompted her to apply to medical school. But she didn’t get in — at least not at first.
“So I spent some time as a soccer coach at Boston University and took some classes so I could show I could get As if I really applied myself,” she says.
She both applied herself and applied to medical school again, this time being accepted into Boston University’s program in 1985. As for her ultimate goal, there was never any doubt:
“I knew from the outset that if I got into medicine that it would be sports medicine,” she says. “And I wanted to be a team physician.”
Putukian continued to coach soccer at summer camps in Lake Placid throughout her time in med school and during her residency and fellowship, channeling her experience working at an indoor tournament into her fellowship research project: an injury epidemiology study of indoor soccer.
About a year later, in 1994, she presented her data at a soccer conference. One of the speakers was describing his career as a US team physician, and Putukian approached him to see how she too could break into the field.
“He literally said, ‘Well you should introduce yourself to the guy right over there.”
The “guy right over there” was the coordinator for US Soccer.
Putukian did introduce herself, and the coordinator asked her if she was an MD. She said yes.
“He’s like, ‘Alright, what are you doing in two weeks? I need a doctor to go to Honduras with the under-19 men.’”
She’s worked with US Soccer ever since, serving as a team physician for both the men’s and women’s teams at multiple levels for roughly three decades.
The US Women’s Soccer Team used to have an interesting tradition. Though, Putukian notes, “There are good reasons why they don’t do this anymore.”
After a match, the 10 or 11 players who hadn’t gotten any time on the field would play a pickup game alongside members of the staff.
“The coaches, the support staff, the video people, the marketing people — we would actually play against each other,” Putukian says. “It was really cool to be playing with the national team because that was one of my dreams, right? To play at the highest level.”
Further, “Being able to work as a team physician with the women’s national team in the late ’90s with Mia Hamm and Tiffeny Milbrett and Kristine Lilly and Briana Scurry was really amazing. You’re amongst the best talented women players in the country — at the time in the world — and you’re helping to take care of them. So that was personally rewarding and fun, and I enjoyed it immensely,” she says.
But to backtrack a bit: While studying for her MD, Putukian took classes with Skip Knuttgen. It was Knuttgen, an ACSM fellow and past president — and ACSM Foundation benefactor — who first introduced her to the college.
“He was the one who encouraged me to join ACSM,” Putukian says.
Knuttgen later moved to Penn State, taking on the directorship of its Center for Sports Medicine. When Putukian completed her residency and fellowship, she followed him there, becoming a team physician. And from 1993 onward, she never missed an ACSM annual meeting.
Putukian spent 11 years at Penn State in various roles, including director of primary care sports medicine, also serving as a physician for several of the school’s teams. In 2004 she joined on with Princeton, likewise ministering to multiple teams and also serving as head team physician and director of athletic medicine.
While at Penn State, she’d begun delving into concussion research in a number of sports, and concussion continued to be an area of interest for her. By 2010, the NFL asked her to join its Head, Neck & Spine Committee. She also began serving as a primary care sports medicine consultant for Major League Soccer in 2014. Four years later, MLS asked her to be their chief medical officer.
“Being a primary care sports medicine physician or a sports medicine specialist, you have a bandwidth that covers issues like cardiac emergency action planning, concussion, musculoskeletal injuries, mental health …” Putukian says. “I believe I was offered the role (with MLS) because of the bandwidth that I had as it related to some of the major issues for soccer.”
During one noteworthy ASCM annual meeting, Putukian attended a presentation about a unique case: A patient had cut his foot while swimming in the ocean, and a bacterium that entered the wound eventually seeded his pubic symphysis — the immovable joint where the two sides of the pelvis meet — causing sepsis.
Putukian was naturally intrigued and filed the presentation away in the back of her mind.
Sometime later, a Princeton soccer player presented with sudden-onset groin pain.
“Last week he was fine, and this week he wasn’t,” she explains. “And on his exam, he was exquisitely tender over his pubic symphysis and had a blister on his foot.”
She sent him to an orthopedic surgeon and shared her suspicion, based on his symptoms and what she’d learned at the ACSM panel, that he might be suffering from an infection. The surgeon agreed it was plausible, and they scheduled an MRI. When the findings came back, they were consistent with Putukian’s educated guess.
“We ended up getting a radiologist to put a needle into the pubic symphysis, and you know, basically it was pus,” she says.
The infection turned out to be methicillin sensitive staphylococcus aureus, or MSSA, which had spread to the patient’s pubic symphysis just as had the marine bacterium in the swimmer’s case.
“It was crazy,” Putukian says. “And then, I’m not kidding you, the very following year I had the same presentation in a basketball player and the same diagnosis made within days.”
Putukian went on to do a presentation about the soccer player’s diagnosis, this time at an AMSSM meeting, to spread the word and, in a way, “pay forward” the crucial information she’d learned at the initial ACSM panel.
Another way Putukian shares her work is via the Team Physician Consensus Conference
(TPCC) documents, a mainstay spinoff event at ACSM’s annual meetings. The TPCC is a project-based alliance where each year, delegates from six sports medicine and related organizations meet to discuss a topic of interest to the team physician. After careful collaboration and rigorous review, the group publishes a consensus statement on the topic in Medicine & Science in Sport & Exercise®.
“ACSM has been a leader in the team physician consensus statements,” she says. “The first one I was involved with was ‘Return to Play,’ and that was in 2003.”
Putukian joined TPCC founders Drs. Stan Herring and Ben Kibler, both FACSM, first participating in the TPCC in ’03 and then becoming a member of the executive writing group a few years later. She has remained a major contributor.
“The three of us ended up really deciding that it was an important series to do every year, and so it’s been something that’s persisted, and ACSM has led the way,” she says.
(In 2024, Lance LeClere, MD, joined the executive writing group as Kibler retired.)
In fact, the TPCC has just finished an update of its very first consensus statement. Fittingly, answering the question “What is a team physician?” And for 2025, they’ll be updating their initial consensus statement on adolescent athletes.
“It’s very satisfying to work on projects like that and then have them published, knowing that it shapes the way people are treating that injury or injuries in particular,” Putukian says.
On the subject of injuries — we chat a bit about low-hanging fruit in terms of improving player health. At the top of the list, Putukian sees an opportunity for minimizing ACL and hamstring injuries. These are particularly important injuries to target, given the amount of time they can take away from a player. An ACL tear brings with it about a yearlong recovery.
“Honestly, the most frustrating thing is that there are some proven prevention methods and protocols that decrease the incidence of ACL injuries by 60% and incidence of hamstring injuries by 30-60%,” Putukian says, noting in particular findings by MLS Research Chair Holly Silvers-Granelli (e.g., 2015, 2017 and 2018). “And yet we can’t get people to implement them. And this is worldwide. Hamstring injuries are the most common injury for soccer, and ACL injuries are often the most severe.”
She highlights the FIFA 11+ and PEP programs as useful interventions. FIFA 11+ focuses on strength, proprioception, balance and neuromuscular function. High-speed running plays a big role, but Nordic hamstrings are the cornerstone exercise.
Putukian sees these exercises as a valuable and underutilized resource.
“FIFA 11+ has been around a long time,” she says.
In fact, Putukian spoke about the issue at the 2024 Isokinetic Conference in Madrid, a cornerstone event for soccer physicians.
“That was one of my take-home messages,” she says. “Emergency preparedness, concussion for sure the second. But the third was hamstring. Those are the three touchpoints that I spoke on, and I think the quote I ended up using was, ‘You can bring a horse to water, but you can’t make him drink. Unless you make him thirsty first.’
“We as scientists, researchers, physicians and sports medicine staffs have to be able to figure out a way to get that message across.”
To close, I ask Putukian what she would tell someone who’s interested in doing what she does. She boils it down to a single principle:
“For me it was a matter of saying yes,” she says. “I said ‘yes’ whenever someone would ask, ‘Will you write this book chapter?’ ‘Yes.’ ‘Will you serve on this committee?’ ‘Yes.’ That allowed me to get my foot in the door. You literally have to say yes because if you say no all the time, they’re going to go to somebody else. I mean, you have to balance that with everything else in your life, but that was how I ended up getting involved with some of the different things I’ve been involved with.”
It’s a recurring refrain I hear from ACSM leading lights and seems to be a reliable method for success.
It’s certainly worked for Dr. Putukian.
Story by Joe Sherlock
Images courtesy of Margot Putukian
Published April 2025
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