This week we have the honor to interview again a group of experts in thermography to discuss the best practices, latest trends and innovation.

Mauricio Elizondo, Director of Sports Medicine, Austin FC (MLS).
Meshari Alwashmi, CEO, AmplifAI Health.
Chris Stackpole, VP Performance, New Jersey Devils (NHL).
Eric Roman, Head Athletic Trainer, Sporting JAX.

Here are the topics that we covered during the video interview:

Q1. Best practices: How should teams actually use thermography? For teams using or considering thermography, what does best practice look like? When should athletes be scanned, how frequently, and how can it realistically fit into the daily workflow of an NHL or MLS , or USL performance department?
Q2. From thermal asymmetry to an actual decision: When you identify a temperature difference or asymmetry, how do you determine whether it is meaningful? How should thermography be combined with GPS, force plates, workload, medical assessments, wellness data and other information to make better decisions?
Q3. Injury risk and the limits of thermography: What can thermography legitimately tell practitioners today about injury risk, inflammation and recovery—and what can’t it tell them? How should teams think about claims around injury prediction?
Q4. What are teams learning today? From what you’re seeing in elite sports today, where is thermography providing the most value? Are there particular injuries, body areas, athlete populations or situations where you’ve found thermal imaging especially useful?
Q5. The future: AI + thermography + multimodal data: Looking 3–5 years ahead, how could AI and thermography evolve together? Could thermal data eventually be combined with workload, movement, sleep, biomarkers and other athlete data to identify changes earlier and potentially help practitioners intervene before a problem becomes an injury?

You can watch the video interview below by clicking on the Youtube link. You can also listen to the audio interview by clicking on the link at the top of the page:

Here are some of the best quotes of our conversation with Chris, Mauricio, Meshari and Eric:

Q1. Best practices: How should teams actually use thermography?

Chris Stackpole — New Jersey Devils (NHL)

“With our NHL schedule and the frequency of games, we’ve found two different pathways for using thermography. On the rehabilitation side, we use it with players who are out for prolonged periods to track their progression back to sport. For healthy players, once or twice a week is probably the maximum we can realistically manage. We try to use the days between games, particularly after days off, to assess players in a standardized way and potentially guide what we’re doing. The challenge is fitting it into an extremely demanding schedule”.

Mauricio Elizondo — Austin FC (MLS)

“For long-term rehabilitation, we can use thermography daily to see how tissue temperature evolves and modify interventions when needed. For team monitoring, we like to scan around match day minus four, approximately 60 hours after the previous game, to understand the player’s response and establish a baseline. If something appears outside that player’s normal profile, we may reassess on match day minus two or minus one to determine whether another intervention is needed”.

Eric Roman — Sporting JAX (USL)

“We’re implementing thermography this year and having players scan daily before training. That allows us to track changes from day to day and understand how each individual responds. Looking ahead, we’re considering scanning both before and after training to better understand the impact of each session on the athlete”.

Meshari Alwashmi — AmplifAI Health

“When we built our thermography solution, we wanted it to fit into the team’s existing workflow rather than force teams to change their routines. That’s why we made it self-operated. Players can take their own images without requiring a staff member to spend time scanning every athlete. The objective is to make thermal monitoring practical and consistent, even when athletes are coming into the facility at different times”.

Recommendations for teams

Adapt scanning frequency to the competition schedule: NHL teams may prioritize 1–2 scans per week, while other organizations may implement daily monitoring.
Prioritize rehabilitation monitoring: Use repeated scans to track individual tissue-temperature changes during recovery.
Standardize scanning conditions: Maintain consistent timing, positioning and environmental conditions.
Minimize workflow disruption: Integrate scanning into existing pre-training or athlete-monitoring routines.

Q2. From thermal asymmetry to an actual decision

Chris Stackpole — New Jersey Devils

“The longitudinal data is the most impactful because tissue temperatures change daily. One interesting thing we discovered when combining thermography with groin strength testing was that the hotter side wasn’t necessarily the weaker side. Sometimes the hotter side was actually stronger, while the opposite side showed a deficit on our force-frame testing. That suggested the stronger side might be compensating and taking on more load. We were able to modify our interventions to address the weaker side while also supporting the side carrying the additional workload”.

Mauricio Elizondo — Austin FC

“The thermal image gives you information, but you need to add context. Sometimes a player has tightness in one adductor, but the opposite side appears hotter. That could indicate fatigue or compensation, and it changes how you approach treatment and workload. If thermography flags a hamstring, Nordic testing shows weakness and the player has just completed a demanding game, you now have several indicators pointing toward the need for further investigation. An asymmetry doesn’t automatically mean there’s an injury. It tells you to look deeper”.

Eric Roman — Sporting JAX

“If thermography flags an asymmetry, you really have to consider everything else. For players returning from surgery or previous injuries, certain areas may show increased temperature after harder sessions. We combine thermography with jump testing, squeeze testing and clinical assessments. If multiple measures are showing abnormalities, that’s when we investigate further. But sometimes we know a particular athlete will have a thermal response in a certain area, so we have to interpret that in context rather than reacting to every change”.

Meshari Alwashmi — AmplifAI Health

“Thermography gives you a signal, and then you need to investigate what that signal means. That’s why we’ve integrated with VALD and wearables such as Oura, Apple and WHOOP. If an athlete isn’t sleeping well, has significant thermal asymmetry and performs poorly on a strength assessment, those are three different signals suggesting something deserves attention. The objective is to bring those signals together and use AI to help practitioners identify potential concerns earlier and make better-informed decisions”.

Recommendations for teams

Establish individual thermal baselines: Interpret changes against each athlete’s historical profile rather than relying only on group averages.
Triangulate multiple datasets: Combine thermography with force plates, GPS, strength testing, wellness and medical assessments.
Investigate rather than assume: A hotter area may reflect compensation, previous injury or normal physiological variation.
Create a decision-making protocol: Define when a thermal flag should trigger additional assessment, athlete communication or workload modification.

Q3. Injury risk and the limits of thermography

Chris Stackpole — New Jersey Devils

“Thermography requires a dedicated process. You need athletes to buy into scanning, you need accurate images, and someone has to interpret the information and decide what to do with it. There are so many factors involved in why athletes get injured that we cannot control. What thermography does well is provide another conversation point about how someone is doing without requiring them to jump, sprint or perform another physical test. But it doesn’t tell you exactly what intervention to make. You still need professional judgment, and there’s noise in the data that you have to work through”.

Mauricio Elizondo — Austin FC

“Thermography is a good tool to add to injury prevention and athlete monitoring, but you can’t simply tell a coach that a player is unavailable because his hamstring is hot. There’s a much bigger assessment process involved. AI interpretation also has limitations, and thermal changes need to be considered alongside everything else we know about the athlete. We need more research, but I believe there’s enough evidence to justify investigating thermography as another monitoring variable”.

Eric Roman — Sporting JAX

“You definitely have to position athletes correctly when capturing thermal images, especially when AI is interpreting them. If the athlete turns slightly or isn’t positioned consistently, the image and the resulting interpretation can change. That’s important when you’re comparing images over time. You need to make sure you’re actually measuring the same areas under similar conditions”.

Meshari Alwashmi — AmplifAI Health

“One limitation is the time required to capture images, particularly when a dedicated practitioner has to perform every scan. We’ve addressed that by developing a self-operated system and using AI on the device to help ensure athletes are positioned correctly before an image is captured. The objective is to improve consistency, reduce the workload on practitioners and allow athletes to participate more actively in their rehabilitation and monitoring”.

Recommendations for teams

Avoid injury-prediction claims: Treat thermography as an additional monitoring signal, not a standalone method of predicting injuries.
Maintain clinical oversight: Thermal abnormalities should prompt further assessment rather than automatic restrictions.
Control measurement variability: Standardize athlete positioning, room temperature, timing and pre-scan activities.
Support further research: More sport-specific studies, particularly in hockey, are needed to establish practical applications and limitations.

Q4. What are teams learning today?

Mauricio Elizondo — Austin FC

“The biggest value I’ve seen is during rehabilitation, particularly with acute injuries. We can track how the temperature of a specific body part changes over time. It doesn’t necessarily guide the entire rehabilitation process, but it often correlates with how the athlete is feeling. We’ve observed temperature decreases following acute injuries, followed by changes as the athlete recovers. We’ve also monitored temperature changes following PRP injections. For me, the most powerful application so far is one-to-one rehabilitation monitoring, where you can track the same tissue over time and compare those changes with symptoms and clinical progress”.

Chris Stackpole — New Jersey Devils

“We had a goaltender with a knee issue where thermography allowed us to see a very localized area of concern. Following an injection treatment, we observed the tissue temperature returning toward its normal baseline as the player’s pain decreased significantly. Being able to show the athlete those changes was valuable. It gives you another objective piece of information to discuss alongside how they’re feeling and progressing through treatment”.

Meshari Alwashmi — AmplifAI Health

“There are still many interesting thermography applications that haven’t been fully explored. One area is understanding how specific interventions, whether injections, acupuncture, heat, cold or exercises, influence tissue temperature. We’ve developed a feature that allows practitioners to compare images before and after an intervention and track the changes over time. The goal is to help teams better understand how athletes respond to different treatments”.

Recommendations for teams

Focus on rehabilitation use cases: Prioritize monitoring athletes recovering from acute injuries, surgery or prolonged absence.
Track responses to interventions: Compare thermal images before and after treatment while also assessing symptoms and function.
Monitor sport-specific body areas: Consider adductors, hamstrings and other areas exposed to high loads, while accounting for individual movement demands.
Use thermal imaging to improve athlete communication: Show athletes changes over time alongside other rehabilitation measures.

Q5. The future: AI + thermography + multimodal data

Mauricio Elizondo — Austin FC

“In the future, I think we’ll see much deeper analysis, potentially down to individual muscles. Maybe cameras will eventually differentiate between the adductor longus and adductor brevis rather than looking at a broader body region. I’d also like to see research examining whether athletes with repeated hamstring injuries share certain thermal profiles. We’ve been collecting data for several years, and the next step is understanding whether there are meaningful relationships between those profiles and injury histories. But we’re still in the data-collection phase, and it’s too early to know whether workload information can reliably explain or predict those temperature changes”.

Eric Roman — Sporting JAX

“I think the future comes back to consistency. The more scans you collect, the more data points AI has to learn from. It will be interesting to go back retrospectively and examine what athletes’ thermal images looked like before an injury occurred. If we can identify consistent trends in those historical datasets, that could help develop better AI models. But the quality and consistency of the data will be critical for making those interpretations meaningful”.

Meshari Alwashmi — AmplifAI Health

“We’re really just scratching the surface when it comes to AI and thermography. We’ve already integrated VALD data and wearable information, and we’re working on bringing those signals together consistently. Our goal is to make it easy for teams to collect different data sources in one place and understand what the results mean. As we continue developing these capabilities, the opportunity is to support more personalized treatment decisions, helping practitioners provide the right intervention to the right athlete at the right time. But consistency and data quality are essential if we want these systems to support meaningful decisions”.

Recommendations for teams

Build longitudinal datasets now: Consistent thermal monitoring creates the historical data needed for future AI analysis.
Integrate complementary technologies: Connect thermography with workload, force plates, movement, sleep and other athlete-monitoring systems.
Explore retrospective injury analysis: Investigate whether meaningful thermal patterns existed before previously documented injuries.
Validate AI-generated insights: Evaluate new algorithms against clinical findings and athlete outcomes before using them to guide decisions.

The Upside Newsletter

⚽Upside Video Chat with Mauricio Elizondo…