On site, ready to rebuild them

As the professional adrenaline-junkies speed down 50-foot-high vertical ramps on skateboards, back-flip off ledges on motorcycles and tail-whip over dirt mountains on tiny bikes, Susan McGowen stands by unflinching.

The on-site medical director at the X Games has seen her share of broken noses, backs, wrists and legs as the athletes strive to go ever higher, farther and faster. Her job is to keep them as safe as possible considering the circumstances -- and to help them when things go wrong.

It’s not employment for the faint of heart, but McGowen is prepared. She has a doctorate in sports administration with an emphasis on risk management, plus she’s a certified athletic trainer and an emergency medical technician.

McGowen sat down with The Times last week during practice at Staples Center.

So who is on your medical team?

I have a staff of 25 certified athletic trainers, two orthopedic surgeons and a whole slew of EMTs to help with stand-by ambulance coverage. At Home Depot Center at any given time we have six EMTs and three ambulances. At Staples we have two ambulances and four EMTs.

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What do you do to prepare for this?

We drill. We have been here four days now. We practice different scenarios. We put helmets on each other and practice how to remove the helmet, and how to backboard an athlete. One of the things we spend the most time on with the emergency action plan is getting them off our courses, off our vert ramp, and getting them to our athletic training facilities and/or an ambulance.

And of course we make sure every single day that we walk the vert ramps and all our courses. We double-check the coping (the metal across the top of the vert ramps where the bikers “grind their pegs.”) And we do screw checks to make sure no screws are sticking out. A skateboarder who puts his hand out could slice it right open. Then, during events we stand ready at the high-risk spots.

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These guys seem so tough, so invincible. Do they seek you all out?

The cool thing for us is how the athletes have responded over the years. The first couple of years it was like, “Who are you guys? What can you do?” Now they come in with pre-existing injuries and want us to help them rehab and treat them and get them better. They have really embraced nutrition. They have embraced weight training. They have embraced preventive measures from injury.

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Are these athletes used to breaking bones?

I don’t know that you ever get used to breaking a bone. But they know that injury is part of the game.

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What is the most common injury you see?

The bike vert riders tend to get more head injuries. With the bike dirt riders, we will see more knee injuries. Our skateboarders tend to get ankle injuries and knee injuries.

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Obviously these guys are thrill seekers. Do you think of them as athletes or superb risk-takers?

Athletes. When you look at the things they are doing, you can see the athleticism. It takes eye-hand coordination, and eye-feet coordination. It takes balance. It takes a great deal of skill for them to be able to do the things they do. I mean, their body awareness is just amazing.

Up in the air, you can see how they twist, how they turn, and they are so aware of their bodies in motion. What they do with their skateboard, bikes and motorcycles is very similar to how a soccer player controls his soccer ball. Only it’s a lot more gutsy. And up in the air. There are definitely some elements of danger involved. But they are total athletes.

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What do you recommend for the average person who is out there watching the X Games and says, “Dude, I am going to go buy a skateboard!”?

I always tell them, first and foremost, get good equipment and wear your protective gear. And I am the advocate of all advocates for helmets.

I don’t care if you are riding a bike, a skateboard, or what you are doing. You need a helmet. Progress slowly. Then, seek advice. There are tons of skate shops and skate clubs out there where you can get involved.

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As someone who is trained to manage risk, do you ever want to stand up and yell, “Stop! Don’t do this!”?

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No. Because we are confident. We are prepared to handle whatever occurs.

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Have you thought of doing some BMX stunts or skateboarding off a 50-foot vert ramp yourself?

I’m a mountain biker and a runner by trade, so no, I’m not a skateboarder. But I have been known to ride a motorcycle.