A third-year resident pokes her head into Dr. Joshua Snodgrass’ office at Long Beach Memorial Medical Center. She has a 21-year-old amateur skateboarder with a broken ankle, but no X-rays on file.
The injury is a week old but is still swollen and bruised.
“Repeat the imaging as quickly as possible so we can actually look at it,” Snodgrass instructs the young doctor.
Under the umbrella of the Family Medicine Residency Program, now in its 50th year at the Long Beach hospital, Snodgrass heads the sports medicine fellowship with an emphasis on action sports, such as skateboarding, in addition to more traditional sports.
Growing up in the 1980s and ’90s, Snodgrass never felt like he was part of any one crowd, but always identified closest with the social outcasts—kids who came from broken homes or had substance abuse problems, though he never partook himself.
“I was not what you would call a good student,” Snodgrass said with a laugh, adding that while he may not have attended all of his classes, he was still absorbing knowledge while crashing his friends’ classes.
“They all knew who I was because I used to fix all their cars for them,” he said of the teachers. “So as long as I wasn’t a ‘bad’ kid, and so long as I was quiet, they would just let me sit there.”
Snodgrass tried his hand at team sports like baseball, soccer and water polo, but he could never get into it. So, naturally, he found himself at the center of the era’s skateboarding counterculture, which ultimately led him into other action sports such as surfing, snowboarding, motocross and more.
“It’s the camaraderie,” he said.
With his mom working as an oncology nurse who worked night shifts and his dad as a fire department battalion chief, he did not see his parents often. Toward the end of high school, Snodgrass said they divorced and moved in with their new respective partners.
“I came home one day and there’s a note on the door that said, ‘The house has been sold, you need to find a place to live,’” Snodgrass recalled. “These outcasts were my family at the time.”
While he was hanging out with the kind of crowd your parents tell you to avoid, Snodgrass said his role was the voice of reason. He would regularly talk his friends “off the ledge” of “some completely dumb thing” and offer ways to mitigate risks.
After graduation, Snodgrass got a job with Ford Motor Company as a mechanic. The company paid for him to attend Riverside Community College.
He tested out of several classes and, instead of wasting free periods, he opted to take other courses out of sheer interest.
“For no apparent reason, I have no idea why, I was like, ‘You know what? I’m going to take biology, I’m going to take chemistry,’” Snodgrass said. “And school started to get fun.”
So he decided to continue his education.
With no family support, he could only afford to apply to two universities: UC San Diego and UC Santa Cruz. The latter sent him the big envelope first, so he packed his bags and moved up north—convincing his girlfriend at the time (who is now his wife) to join him.
The move was pivotal in his educational journey. He found himself washing glasses in a neurogenetics lab under Principal Investigator Yishi Jin, who previously had contributed to the genetics work of Sydney Brenner, H. Robert Horvitz and John E. Sulston, which was awarded the Nobel Prize in Physiology or Medicine in 2002.
While working in the lab, Snodgrass shared bench space with David Hassler, who was involved in the decoding of the human genome.
“These were my influences, who I looked up to during my undergrad,” Snodgrass said. “Being around all these super bright and influential people … they just kind of steered me. These people were the ones that influenced my decision to enter into medical school.”
With limited funds and the desire to keep surfing, Snodgrass’ medical school options were limited. He wound up at Ross University in the Caribbean. From there, he picked up rotations at hospitals around the country, including New York, Chicago and Miami before landing a residency in Phoenix, where his brother lived.
The sports medicine fellowship at Arizona State University had lost its accreditation, which allowed Snodgrass to fill the gap by doing an elective rotation at the school, working with the rugby and hockey teams.
“It was really fun to get in there because I got a lot more experience,” Snodgrass said.
Through work at a women’s prison, where he was doing obstetrics and wound care exams, he was introduced to Dr. Robb Blackaby, co-founder of Medicine in Motion, a sports medicine company that provides health care services to athletes at events worldwide. The relationship led him back to Southern California as the first fellow for the sports medicine fellowship at Long Beach Memorial.
“One of the draws for me to come to this program was the ability to kind of tailor it to whatever I wanted,” Snodgrass said, which allowed him to focus his work on action sports.
“When I initially approached MemorialCare for the fellowship spot, I showed [Dr. Jeffrey Lai] the evolution of action sports,” Snodgrass said. “It was kind of overwhelming because they were amped about it. They really understood the drive behind me.”
During his fellowship, Snodgrass reached out to old contacts, which led to him regularly being a medic at the Pro-Tec Pool Party skateboarding contest, Shaun White’s Air + Style event and the X Games.
When Snodgrass graduated from the fellowship, he got a job in San Diego for a company that handles workers’ compensation claims.
“It was a rough point in my life,” he said, noting the broken system that saw insurance companies denying legitimate claims and individuals trying to embellish their situation for more money.
“It was wearing on me to the point where I had legitimately considered leaving medicine as a whole,” Snodgrass admitted. He even went as far as going back to school and earning a master’s degree in cybersecurity.
Fortunately, Dr. Lai decided he wanted to go into private practice in 2018 and offered Snodgrass the lead role at MemorialCare’s sports medicine fellowship. He jumped at the opportunity.
Having been a forerunner in the program, Snodgrass was ready and hit the ground running. He continued providing care at the X Games, which he has done every year since 2015, and brought along his fellows who were interested in treating extreme athletes.
Treating athletes that are pushing the boundaries every day in their respective sports is a challenge, Snodgrass said—especially when it comes to action sports, which spawned from a counterculture with no rules to break. But with events slowly being accepted into the Olympics, the outlaw ways are changing.
“There’s this weird shift because, historically, in the action sports industry, taking a big hit or slam was like a badge of honor,” Snodgrass said, noting that people are more worried about serious injuries nowadays. “Everything is moving toward being more professional.”
The Olympics, for example, has drug testing requirements for extreme sports just like all others, Snodgrass said. Outside of that, however, drug testing is not done at competitions, he added.
Just getting pre-event physicals or having athletes wear helmets is a challenge, he said. It is a fine line to sympathize—or, in Snodgrass’ case, empathize—with the culture while trying to protect them.
“We know people are going to do certain things, and we know that they’re gonna get hurt along the way,” Snodgrass said. “But that’s how you advance sports. That’s the nature of it.”
Snodgrass recalled his first day of high school. When he rolled up on his skateboard, a supervisor grabbed him by the backpack and pulled him off his board, saying he’s tired of telling students they “can’t do that here.”
“It was burned into my brain, and the next four years was people telling me what I can’t do,” Snodgrass said. “And I love action sports for its mindset: There’s always someone out there telling you ‘you can’t do that,’ but here are all these athletes that are proving people wrong, saying ‘watch me.’”
Snodgrass also is no stranger to taking big hits. Skating for decades, he had his fair share of falls, but his worst injury came ahead of the 2020 X Games while preparing other medics for the event. Snodgrass went to slide down one of the ramps when his shoe caught and his ankle snapped.
Now, years later, he is still unable to skate or snowboard like he used to. He can cruise on both, but any tricks and even simple carving is out of the question.
His injury, though, has not kept him from doing what he loves: teaching and working with extreme athletes.
“I’m really fortunate to have the backing of a hospital network that wants us to advance the sports medicine side so we can actually attack those underserved sports areas,” Snodgrass said, adding that “you shouldn’t be beating your head against the wall every day, what you do in life should be fun.”
While Snodgrass’ passion is working with action sports, he understands that not all sports medicine doctors will have the same love for the culture. To that end, the fellowship also works with more traditional sports.
Snodgrass is the team physician for Long Beach State Athletics and works with the athletics departments at Cypress College and Biola University.
For each fellow that comes through his program, Snodgrass said he works to understand their goals and desired career path so that he can help facilitate it—regardless of the sport, which at this point has included weightlifting and combat sports.
“Even if it’s outside my comfort zone, I’m OK with it,” Snodgrass said. “I want to build the best education for the fellows that come through this program so we can create better sports docs in the future.”
For Snodgrass, though, it always comes back to his counterculture roots and treating extreme athletes, who oftentimes grew up without the financial—or any—support system that other athletes did.
“Football is one of the most popular sports in the country and those kids grew up with family support, coaching staff, athletic trainers, locker rooms, booster clubs,” Snodgrass said, noting that his care is a crucial resource. “And then you look at these alternative sports: they don’t have anyone teaching them or coaching them along the way.
“There’s a lot more risk associated with those action sports athletes just because they don’t have as big of a support network as most organized sports.”