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American Association for Physician Leadership
American Association for Physician Leadership

Quality and Risk

Team Trainer/Physician Leadership and NIL – The Dangers of NIL for Student-Athletes and Universities

Timothy E. Paterick, MD, JD, MBA


The evolving NIL laws, rules, and policies are new and often complicated and the potential huge financial deals make infractions possible, as this case exposes.

It’s time for March Madness. The hype and frenzy rise to a fever pitch. Players and teams are in a win-or-go-home moment. The teams and players are in a state of ecstasy or despondency. Those who lose often dream of a new home where the grass is greener and the NIL (name, image, likeness) benefits are real.

Because players in this conundrum often confide in and look for advice from their team trainers/physicians, it’s prudent for team trainers/physicians to be aware of relevant NIL laws, rules, and policies. With this knowledge, they can advise student-athletes to see the university legal staff.

NCCA’s First NIL-Related Infraction Case

On February 24, 2023, the NCAA released a decision in its first NIL–related infraction case. The alleged infraction was impermissible recruiting contacts and inducements in the University of Miami’s women’s basketball program.

Although the infractions case did not involve any direct violation of the NCAA’s NIL rules or policies, it did involve John Ruiz, a University of Miami booster who has used social media to highlight his NIL deals with student-athletes at the University of Miami.

The NIL infractions case involved the Cavinder twins.

Who Are the Cavinder Twins?

Haley and Hanna Cavinder are identical twin 5-foot-6 guards who combined to average 34.2 points per game in their three seasons at Fresno State and built an enormous social media following during the pandemic. They each have 400,000 Instagram followers and 4 million more on their shared TikTok account which mostly features them dancing side-by-side.

The Cavinders became stars of the NIL era as soon as it became officially an option for college athletes on July 1, 2021. Boost Mobile signed them and advertised the partnership with a large advertisement in New York's Times Square. Other deals included ones with Champs Sports, Eastbay, and apparel company PSD. They also can be hired through the site Cameo for personalized video messages or as spokespersons for a business.

The Facts Surrounding the Infraction

The Cavinder twins were in the transfer portal at the time they and their parents had dinner at Ruiz’s home prior to committing to the University of Miami for their senior year.

The NCAA was made aware of the dinner because Ruiz posted a picture of the dinner on social media. It was identified that the University of Miami’s coaching staff had a role in connecting the Cavinder twins to Ruiz.

What Happened Procedurally?

Following an investigation by the NCAA’s enforcement staff, the Cavinder/Ruiz case was submitted to the NCAA Division 1 Committee on Infractions (COI) through the association’s negotiated resolution process, which is implemented when all parties (NCAA enforcement staff, the University of Miami, and the head women’s basketball coach) agree on the facts, violations, and appropriate penalties. The process does not move forward to a contested hearing before the COI and has no precedential value.

Is There a Recruiting Rule Violation?

The parties to the alleged infraction all agreed that the coaching staff’s facilitation of a meeting between the Cavinder twins and Ruiz violated the NCAA recruiting rules.

The recruitment of prospective student-athletes is limited to coaches and the athletic staff. Boosters and NIL collectives are not allowed to participate in the recruiting process. Coaches cannot connect prospects to boosters or collectives to discuss specific NIL opportunities before the student-athletes signs with a specific school.

What Are the Penalties?

The parties to the NIL-related infraction agreed that the recruiting violation occurred. The penalties for the violation included:

  • The university’s head women’s basketball coach was suspended for three games.

  • The university was placed on probation for one year.

  • The university was fined $500,000 plus 1% of the women’s basketball budget.

  • There were outlined recruiting restrictions.

  • The NCAA did not penalize the Cavinder twins.

The penalties could be characterized as mild. Even more surprising, the NCAA did not require that the university severe their relationship with Ruiz, which is frequently the penalty doled out by the COI when a booster is involved with an infractions case.

However, the COI seized this opportunity to underscore that it will utilize the disassociation penalty for boosters who participate in impermissible NIL activity in the future.


This case is important for team trainers/physicians to be aware of because conversations in the training room between trainers, physicians, and student athletes surface issues that raise concerns of NIL-related infractions.

It would be prudent for trainers/physicians to know that businesses, boosters, and NIL collectives that are looking to work with student-athletes with NIL deals often put student-athlete eligibility at risk because the zealous desire to secure the student-athlete’s NIL. Trainers/physicians should know the relevant NIL laws, rules and regulations to help protect the student-athletes and the universities.

The evolving NIL laws, rules, and policies are new and often complicated and the potential huge financial deals make infractions possible, as this case exposes. When issues are surfaced in the training room, it behooves all trainers and physicians to refer the student-athlete to the university’s legal staff.

Timothy E. Paterick, MD, JD, MBA

Timothy E. Paterick, MD, JD, professor of medicine, Loyola University Chicago Health Sciences Campus in Maywood, Illinois.

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