Sport Science in Rehab: A Multidisciplinary Approach to Athlete Recovery (f Adam Loiacano)

WEBVTT

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Awesome.

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Ready?

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Ready.

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Perfect.

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So I'm here with Adam Loyacono.

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Been in the NBA for, what, six,

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seven years between the

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Hawks and the Suns.

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Background in MLS and NWSL as well.

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So we've got some common themes there.

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For people who don't know you, Adam,

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can you give everybody a

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little bit of your

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professional background and

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a little about you time?

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Sure thing, man.

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This is going to be fun.

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I'm excited to catch up with you.

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I know we always have fun

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talking with each other.

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So yeah, I was started in MLS,

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started with the Youth

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Academy coaching youth soccer,

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but then also transitioned

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more into a fitness role at

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the Youth Academy and then

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graduated to the first team with them for,

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I think,

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four or five seasons in addition

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to the Youth Academy.

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I was lucky enough to spend

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one year as well down in

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Orlando with the NWSL.

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Great opportunity working

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with women's soccer.

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I mean, at the time,

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the league was so young,

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so just really refreshing.

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And they were so

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appreciative of any help

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that they could get.

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So it was a really cool

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experience to be a part of that group.

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And then had an opportunity

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to join the Atlanta Hawks in the NBA.

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So part of soccer was more

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sports science and performance.

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And then after getting my

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doctorate of physical therapy,

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transitioned more into the medical side,

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and that's where I spent

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most of my time in the NBA.

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Atlanta two years as a

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performance therapist,

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and then transitioned out

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to Phoenix to be director

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of rehab and later director

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of performance as well for five seasons.

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Awesome, man.

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That's a heck of a career.

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We'll keep it mostly NBA

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focused here just for the

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theme of the podcast.

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But if you end up with good

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stories or suggestions from

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the Sagers place, please drop them in.

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I know across kind of such a

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breadth of experience in

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rehab and in performance

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that your views on the

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rehab continuum or phases

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of rehab have changed.

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got to be interesting and

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have developed over the years.

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Can you speak to like your

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rehab continuum or do you

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have a five phase approach,

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a seven phase approach?

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How do you look at return to play?

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That's a really,

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that's a really good question.

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We can really get lost in the weeds here.

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So let's we'll zoom out first.

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And I think we'll talk about

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a few frameworks that I

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like to refer to just how I

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organize my thoughts, right?

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Like frameworks and models are how we all.

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just organize how we think right,

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wrong or indifferent is

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just the way my mind thinks.

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So like very, very high level,

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I think of systems and I think like,

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how do I reverse engineer a system?

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Because that's inevitably

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what we're doing here, right?

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Whether it's team sports,

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whether it's a human being,

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whether it's an injury,

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whether it's a performance program,

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at the end of the day,

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you're trying to accomplish

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a terminal task.

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And within that is a big system,

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either multiple disciplines,

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multiple people.

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And then also you have to

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reverse engineer that

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because you need time to either

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rehab that injury or to

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build that person up from a

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performance training

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program so I tend I tend to

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break it down from working

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in team sports for so long

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and having the opportunity

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to work a lot of different

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practitioners I break it up

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into five key phases and

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like I love the word that

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you use was continuum

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because that's really what

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it is there's really no

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definitive line of like hey

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this is when you're an x

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and then this is when

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you're in y it's like no

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there's like there's gray

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space everywhere but the

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ends of the continuum are

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definitely black and white

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And so if we like think about,

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let's just say early, right?

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Early,

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we're talking the context of rehab

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and injury,

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but if they're the same

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principles apply when it

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comes to performance

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training or sports science, right?

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Because they're all

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intertwined with one another.

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Like we live in a world

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where nothing is in isolation anymore,

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very integrated,

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especially with a lot of

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the work that you're doing

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around data and trying to

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understand load management better.

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We understand that all of

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that is connected.

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So let's just say the first

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phase of it I refer to as health, right?

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Health is exactly what it is.

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Restoring homeostasis,

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trying to bring the tissue,

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bring the human,

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bring the system back to a

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space where they're not stressed,

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they're not overworked,

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and they're just at a

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optimal state to then make adaptations.

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Then the second phase of

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that I look at is therapy.

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And therapy to me is where

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we really influence the

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motor learning and part-task strategies.

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So if you're in the performance world,

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that's maybe your corrective exercises,

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or that's maybe your reset,

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as some folks like to say.

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Or if you're in the physical

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therapy space or the physio space,

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athletic training,

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you're rehabbing an injury.

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That's maybe your first

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seven to 14 days are really

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just focusing on these part

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task strategies,

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these really local

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qualities that we want to

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develop because we know you

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can't train the system with

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a broken part.

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Right.

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For lack of better terms.

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So you want to enhance the

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part as best you can and

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knowing very well,

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knowing that that's going

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to continue to enhance as

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you train the system.

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So then from you have health,

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then you go to therapy.

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Then after therapy is training, right?

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So training to me is defined

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as like the whole task strategies,

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the whole body movements.

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This is where everybody loves to be.

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It's the fun stuff.

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It's where you're really not

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dealing with pain.

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You might deal with some of

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it right as you start to introduce it.

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But this is really,

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really where the athlete

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gets an opportunity to feel

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like themselves because

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they've either been on the

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shelf for a little while or

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Or from an athlete that's in

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the training space,

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you kind of got past the warmup,

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you got past the correctives,

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and now you're in a space like, okay,

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cool, let's get after it.

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So to me, that's what training is, right?

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Whole task strategies and

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integrating the parts, quote unquote,

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that you've been working on

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to then create a global strategy.

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Then the fourth phase of

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that to me is the performance space.

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And so the performance space

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is really fun too,

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because it becomes

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competition against themselves, right?

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You're trying to chase these exact goals,

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either through tech, through data,

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through competition with

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themselves or with others.

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And you're specifically

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targeting a particular

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adaptation or particular quality.

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And what I mean by that is

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maybe you're chasing 10

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meter sprint speed and

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maybe you're chasing lower body strength.

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Maybe you're chasing upper body power,

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whatever it is.

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That's where you're measuring these,

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what I call like external outputs.

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Whereas like back in the

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therapy side of the continuum,

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those are your external inputs,

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so to speak.

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So inputs early on, outputs later on.

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And then the final phase,

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the final phase of it is the sport phase.

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But I kind of like and we

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can get into the weeds on this,

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but I think the sport phase

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underlies all of it,

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because at any given time,

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you can still be participating in sport,

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whether it's early rehab, middle rehab,

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early training, late training.

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But along a continuum where I say, hey,

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like you have sport of one

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far end and you have health

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at one far end.

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And I intentionally think

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that way because.

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One phrase I catch myself

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saying is a healthy athlete

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is an oxymoron.

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I think when you're talking

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about high level athletes,

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unless they're playing one

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competition a week or one

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competition every two or three months,

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which is not the norm anymore,

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like from the time of

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business side of things,

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there's so much competition

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to generate revenue that

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when you start having these

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high stressful events back to back,

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two games every three days,

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whatever it may be,

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the body just doesn't recover that well.

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So I think the idea of a healthy athlete

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is an oxymoron it's just an

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expression I remind myself

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to say hey there's going to

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be stuff that you can't

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change you just got to

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manage it and it may not be

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ideal but at the end of the

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day they're still going to

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go out and participate in

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that sport so how you make

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them optimal for what they

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have to do yeah I oh man I

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would echo a lot of that I

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think at three and a half

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games a week in the nba like

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I mean,

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it's nearly impossible to play all

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82 and to be healthy, right?

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Like you are at some point

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patchworking guys together.

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They have periods that they

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feel great and they have

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periods they feel bad and they play.

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But if you look back to last

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season in the top 50 scores,

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only one in the top 50

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played all 82 games.

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it is very much an oxymoron.

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I think it's good to remind

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yourself when you're

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working in that space and

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for people interested in that space,

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like you're not going to

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keep an entire roster

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healthy and all available for all 82.

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It's just an unreasonable expectation,

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but to your, to your rehab continuum,

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which I really appreciate

00:07:17.427 --> 00:07:19.968
that it's not phase one, phase two,

00:07:20.108 --> 00:07:20.629
phase three,

00:07:20.649 --> 00:07:21.689
like it's not this very

00:07:22.670 --> 00:07:24.430
numeric linear direction.

00:07:24.451 --> 00:07:25.732
Cause it feels like you can

00:07:25.791 --> 00:07:27.353
blend between those spaces, but

00:07:28.305 --> 00:07:31.689
How do you look at advancement criteria,

00:07:31.728 --> 00:07:32.529
whether between those

00:07:32.589 --> 00:07:33.971
spaces or in those spaces?

00:07:34.052 --> 00:07:36.394
So is it heavily weighted to

00:07:36.514 --> 00:07:37.394
subjective moments?

00:07:37.456 --> 00:07:38.976
Is it heavily weighted

00:07:39.036 --> 00:07:40.499
towards objective testing?

00:07:40.559 --> 00:07:42.240
Feel free to use an example if you need to,

00:07:42.281 --> 00:07:43.723
but speaking to how do we

00:07:43.762 --> 00:07:45.584
advance across a continuum like that?

00:07:46.963 --> 00:07:48.384
That's the golden question

00:07:48.403 --> 00:07:50.204
that everybody wants the secret sauce to,

00:07:50.244 --> 00:07:50.403
right?

00:07:50.423 --> 00:07:52.365
And that's what's fun about practicing.

00:07:52.404 --> 00:07:53.725
You got the sauce, though.

00:07:53.745 --> 00:07:54.886
You've been doing it forever.

00:07:55.665 --> 00:07:56.826
No, I'd like to think so,

00:07:56.867 --> 00:07:58.107
but my sauce is still refining,

00:07:58.286 --> 00:07:59.047
kind of like fine wine.

00:07:59.067 --> 00:08:01.668
It gets better with time.

00:08:01.708 --> 00:08:02.488
I would say this.

00:08:02.548 --> 00:08:03.629
I think it's definitely a

00:08:03.689 --> 00:08:04.608
combination of it all,

00:08:04.629 --> 00:08:05.889
and that's not the cop-out answer.

00:08:05.910 --> 00:08:07.029
That is genuinely like, hey,

00:08:07.170 --> 00:08:08.290
there's going to be moments where

00:08:08.891 --> 00:08:10.771
Your objective tests tell you this,

00:08:10.992 --> 00:08:12.432
but subjectively the athletes like, man,

00:08:12.452 --> 00:08:14.355
like I can go, like, I trust myself.

00:08:14.435 --> 00:08:15.074
I feel good.

00:08:15.095 --> 00:08:15.214
Like,

00:08:15.295 --> 00:08:16.696
I know my numbers are a little bit down,

00:08:16.716 --> 00:08:17.677
but man, I just feel good.

00:08:17.716 --> 00:08:19.077
Like I had a bad test like that just.

00:08:19.677 --> 00:08:20.418
And so there's always that

00:08:20.499 --> 00:08:22.120
balance of the subjective and objective.

00:08:22.579 --> 00:08:23.901
So as far as criteria,

00:08:23.920 --> 00:08:24.841
I think the first thing you

00:08:24.880 --> 00:08:26.262
have to talk about and you have, like, we,

00:08:26.742 --> 00:08:27.903
we can never lose sight of

00:08:27.942 --> 00:08:29.483
this because I think when

00:08:29.504 --> 00:08:31.625
the pressure's on or.

00:08:32.947 --> 00:08:34.187
there's a strong desire to

00:08:34.227 --> 00:08:35.448
go out and be a good teammate.

00:08:35.489 --> 00:08:36.951
Like we can't ignore biology.

00:08:37.091 --> 00:08:39.413
We can't ignore healing timelines.

00:08:39.452 --> 00:08:40.774
We can't ignore the clinical

00:08:40.813 --> 00:08:41.754
symptoms that we may see.

00:08:42.155 --> 00:08:43.076
So I think it's very important.

00:08:43.096 --> 00:08:44.738
You just have to respect that biology.

00:08:44.758 --> 00:08:45.859
And I mean, I'll just leave it at that.

00:08:45.879 --> 00:08:47.039
It's like respect biology,

00:08:47.200 --> 00:08:48.280
understand what a normal,

00:08:49.355 --> 00:08:50.495
healing timeline can be.

00:08:50.815 --> 00:08:53.115
And irregardless of infrared light,

00:08:53.235 --> 00:08:54.576
cold plunge, sauna,

00:08:54.975 --> 00:08:55.875
there's just things that we

00:08:55.956 --> 00:08:57.836
can't expedite all that much, right?

00:08:57.856 --> 00:08:58.716
There's a reason why a

00:08:58.777 --> 00:09:00.517
broken bone still takes

00:09:01.197 --> 00:09:01.897
four to eight weeks,

00:09:01.937 --> 00:09:02.937
depending on the age of the

00:09:02.998 --> 00:09:05.457
bone and the specific bone that you had.

00:09:05.477 --> 00:09:07.217
So let's just be honest and say, hey,

00:09:07.519 --> 00:09:08.298
there's a lot of great

00:09:08.359 --> 00:09:10.418
stuff that may push 1%,

00:09:10.418 --> 00:09:11.958
but 80 to 90% of the stuff

00:09:12.058 --> 00:09:13.120
is just rooted in good

00:09:13.159 --> 00:09:13.899
biology and having an

00:09:13.919 --> 00:09:14.740
understanding of that.

00:09:15.080 --> 00:09:15.600
And I think you can,

00:09:15.961 --> 00:09:16.900
I like to just break things

00:09:16.941 --> 00:09:18.662
down by tissue types, whether it's muscle,

00:09:18.741 --> 00:09:19.903
ligament, tendon, bone,

00:09:19.942 --> 00:09:21.003
just understanding what

00:09:21.043 --> 00:09:22.264
that pathway is and those

00:09:22.323 --> 00:09:24.304
progressions then allow you

00:09:24.365 --> 00:09:25.725
to give the space to get

00:09:25.826 --> 00:09:27.287
creative within each of those,

00:09:27.726 --> 00:09:28.967
let's just say, excuse me,

00:09:29.128 --> 00:09:30.467
healing timelines that exist.

00:09:30.488 --> 00:09:31.649
So that's the first part

00:09:31.688 --> 00:09:32.428
that you just have to

00:09:32.509 --> 00:09:33.429
understand and respect.

00:09:34.269 --> 00:09:35.370
And I think if you ignore that,

00:09:35.390 --> 00:09:35.850
you're going to run

00:09:35.870 --> 00:09:37.131
yourself into some problems or

00:09:37.964 --> 00:09:39.205
potentially be doing harm

00:09:39.245 --> 00:09:40.346
more than good or

00:09:40.407 --> 00:09:41.368
potentially getting to a

00:09:41.427 --> 00:09:42.068
space where you're thinking

00:09:42.089 --> 00:09:43.029
you're making good progress.

00:09:43.070 --> 00:09:44.510
And then all of a sudden you realize, man,

00:09:44.812 --> 00:09:45.753
I rushed that phase and now

00:09:45.793 --> 00:09:46.894
I got to take two steps back.

00:09:47.374 --> 00:09:49.437
So I think that's the first part of it.

00:09:49.476 --> 00:09:50.918
And then the second part is criteria.

00:09:50.937 --> 00:09:51.719
And I think that's the fun

00:09:51.778 --> 00:09:53.681
part of the rehab space,

00:09:53.721 --> 00:09:54.542
the performance therapy,

00:09:54.562 --> 00:09:55.703
the strength and conditioning, because

00:09:56.104 --> 00:09:57.424
There's so many tools in our

00:09:57.465 --> 00:09:58.905
toolbox now with the influx

00:09:58.946 --> 00:10:00.485
of technology being more affordable,

00:10:00.947 --> 00:10:01.586
with the amount of

00:10:01.647 --> 00:10:02.587
middleware companies that

00:10:02.628 --> 00:10:03.888
are processing data for us,

00:10:03.967 --> 00:10:06.089
with the massive boom in

00:10:06.230 --> 00:10:07.190
artificial intelligence.

00:10:07.250 --> 00:10:08.431
I'm so excited to see where

00:10:08.451 --> 00:10:09.711
that takes the data and

00:10:09.750 --> 00:10:10.851
training aspects for us

00:10:11.351 --> 00:10:12.533
that it really becomes

00:10:12.692 --> 00:10:13.793
endless possibilities when

00:10:13.833 --> 00:10:14.833
it comes to criteria.

00:10:15.134 --> 00:10:15.774
But I think you have to

00:10:15.815 --> 00:10:16.855
break it down logically and

00:10:16.914 --> 00:10:17.456
ask yourselves,

00:10:17.515 --> 00:10:18.076
what are the key

00:10:18.115 --> 00:10:19.956
constituents of this world?

00:10:20.037 --> 00:10:21.518
rehab case of this injury

00:10:21.557 --> 00:10:22.979
that I need to make sure

00:10:22.999 --> 00:10:24.480
are in an adequate space.

00:10:24.520 --> 00:10:24.860
So let's just,

00:10:24.880 --> 00:10:27.523
I think the classic example is an ACL,

00:10:27.663 --> 00:10:27.802
right?

00:10:27.822 --> 00:10:28.464
I think everyone loves to

00:10:28.504 --> 00:10:29.464
talk about an ACL and for

00:10:29.865 --> 00:10:30.544
maybe not even ACL,

00:10:30.565 --> 00:10:32.145
let's just talk about a knee, right?

00:10:32.186 --> 00:10:32.687
And a knee,

00:10:32.746 --> 00:10:33.768
we know we want to see full

00:10:33.827 --> 00:10:34.408
range of motion.

00:10:34.447 --> 00:10:36.230
We know we want to see quadriceps strength,

00:10:36.350 --> 00:10:37.409
maybe hamstring strength,

00:10:37.431 --> 00:10:39.192
depending on the type of injury,

00:10:39.231 --> 00:10:40.011
but probably want to see a

00:10:40.052 --> 00:10:41.413
good balance of ratio there.

00:10:41.433 --> 00:10:41.634
And that's

00:10:42.354 --> 00:10:43.754
well understood and studied

00:10:43.815 --> 00:10:44.495
in the research of

00:10:44.674 --> 00:10:45.775
hamstring to quad ratio,

00:10:45.836 --> 00:10:47.557
quad to hamstring ratio,

00:10:48.076 --> 00:10:49.518
percentage of body weight

00:10:49.618 --> 00:10:50.498
on peak torque of a

00:10:50.557 --> 00:10:51.798
quadriceps strength exercise.

00:10:52.158 --> 00:10:54.019
These norms exist of just

00:10:54.220 --> 00:10:55.400
absolute measures that, hey,

00:10:55.441 --> 00:10:56.221
we all should probably be

00:10:56.240 --> 00:10:56.941
hitting these measures,

00:10:57.322 --> 00:10:58.422
irregardless of the injury,

00:10:58.522 --> 00:10:59.663
irregardless of the athlete.

00:10:59.722 --> 00:11:01.624
Because if we hit these numbers,

00:11:01.663 --> 00:11:02.663
if we hit these external

00:11:02.764 --> 00:11:03.445
outputs from the

00:11:03.485 --> 00:11:04.465
performance side of the containment,

00:11:04.485 --> 00:11:05.946
if we hit these external outputs,

00:11:06.326 --> 00:11:07.287
Then we at least say, hey,

00:11:07.647 --> 00:11:08.687
we're in a safe space.

00:11:08.807 --> 00:11:09.889
We're based on the literature.

00:11:10.229 --> 00:11:11.970
If you hit these external outputs, right?

00:11:12.009 --> 00:11:13.510
If you hit this lower body strength,

00:11:13.551 --> 00:11:15.312
if you hit this 10 meter sprint speed,

00:11:15.352 --> 00:11:17.494
if you hit this peak torque

00:11:17.533 --> 00:11:18.754
on isokinetic knee strength,

00:11:19.095 --> 00:11:20.035
that you're less likely to

00:11:20.056 --> 00:11:21.317
get injury or less likely

00:11:21.336 --> 00:11:22.298
to have a re-injury, right?

00:11:22.337 --> 00:11:22.957
That's where all the

00:11:22.998 --> 00:11:23.818
information I think the

00:11:23.839 --> 00:11:25.000
standards come from are

00:11:25.299 --> 00:11:26.220
these regression models

00:11:26.240 --> 00:11:28.101
that just take time and data to build.

00:11:28.381 --> 00:11:29.363
And we're starting to reap

00:11:29.403 --> 00:11:30.683
those benefits of a lot of

00:11:30.703 --> 00:11:31.384
that coming through.

00:11:31.403 --> 00:11:33.164
So then you create these standards of,

00:11:33.245 --> 00:11:33.466
okay,

00:11:33.485 --> 00:11:34.647
this is what I want to see for knee

00:11:34.667 --> 00:11:34.927
strength.

00:11:35.326 --> 00:11:36.128
This is what I want to see

00:11:36.148 --> 00:11:36.969
from my forest plates.

00:11:37.528 --> 00:11:38.669
This variable is important.

00:11:38.809 --> 00:11:39.530
This variable is not

00:11:39.571 --> 00:11:40.350
important because this

00:11:40.432 --> 00:11:41.812
research paper was able to study that.

00:11:42.153 --> 00:11:43.614
So it's a fine balance of

00:11:44.455 --> 00:11:46.557
criteria in respecting biology.

00:11:46.937 --> 00:11:48.238
And I think for me,

00:11:48.599 --> 00:11:49.458
the tools that you have

00:11:49.940 --> 00:11:50.780
within your toolbox,

00:11:51.160 --> 00:11:51.961
everybody's got different

00:11:52.261 --> 00:11:53.663
accessibility to a lot of

00:11:53.682 --> 00:11:54.163
different things.

00:11:54.203 --> 00:11:54.964
You and I have been very

00:11:55.043 --> 00:11:56.466
fortunate working in pro sports that

00:11:56.946 --> 00:11:58.067
kind of unlimited resources.

00:11:58.086 --> 00:11:58.947
Like you need something for

00:11:58.966 --> 00:12:00.609
the sake of a multimillion dollar athlete,

00:12:01.028 --> 00:12:02.090
organization is gonna support you,

00:12:02.110 --> 00:12:02.669
you'll get that.

00:12:03.049 --> 00:12:04.410
And the context of maybe gen

00:12:04.451 --> 00:12:05.552
pop where you don't have that,

00:12:06.332 --> 00:12:07.133
there's still a lot of

00:12:07.293 --> 00:12:08.913
principles that underlie a

00:12:08.974 --> 00:12:10.115
lot of the high end tech

00:12:10.495 --> 00:12:11.355
that still applies.

00:12:11.375 --> 00:12:11.995
Like you don't need an

00:12:12.116 --> 00:12:13.878
isokinetic strength test to

00:12:13.918 --> 00:12:15.158
go test quadriceps strength.

00:12:15.499 --> 00:12:18.041
Do a five rep max on the unaffected leg

00:12:18.620 --> 00:12:19.922
Can you do the same on the other leg?

00:12:20.182 --> 00:12:21.583
As simple and as easy as that is,

00:12:21.604 --> 00:12:23.125
I promise you that is a

00:12:23.186 --> 00:12:24.366
proxy that I use all the

00:12:24.407 --> 00:12:25.187
time with professional

00:12:25.268 --> 00:12:26.149
athletes and saying, hey,

00:12:26.570 --> 00:12:27.770
let's just get on the leg extension.

00:12:27.811 --> 00:12:28.932
Let's just get on this machine.

00:12:29.413 --> 00:12:30.134
Show me what you can do on

00:12:30.173 --> 00:12:31.095
one side versus the other.

00:12:31.514 --> 00:12:32.755
And it's not perfect.

00:12:32.897 --> 00:12:33.616
It's not science,

00:12:33.857 --> 00:12:35.019
but I'm measuring external

00:12:35.099 --> 00:12:36.200
outputs and I'm measuring

00:12:37.081 --> 00:12:38.121
over time and progress.

00:12:38.142 --> 00:12:38.743
And that's probably the

00:12:38.802 --> 00:12:39.964
biggest thing when it comes to

00:12:41.158 --> 00:12:42.298
the topic of criteria

00:12:42.318 --> 00:12:43.480
progression is just having

00:12:43.580 --> 00:12:46.802
consistent tests that you use that are,

00:12:47.162 --> 00:12:47.822
this gets back to the

00:12:47.881 --> 00:12:48.863
conversation of validity

00:12:48.883 --> 00:12:49.663
and reliability and

00:12:49.702 --> 00:12:50.903
relevance and irrelevance.

00:12:50.943 --> 00:12:52.245
Like what makes the most

00:12:52.304 --> 00:12:53.645
sense based on the injury type,

00:12:54.206 --> 00:12:55.706
tissue type affected and

00:12:55.726 --> 00:12:57.028
what they're gonna have to do in the end.

00:12:59.409 --> 00:13:00.090
Yeah,

00:13:00.230 --> 00:13:01.390
first I'm gonna appreciate and

00:13:01.410 --> 00:13:04.393
highlight your commentary

00:13:04.452 --> 00:13:05.693
on the bone healing.

00:13:06.660 --> 00:13:07.543
versus kind of the soft

00:13:07.582 --> 00:13:09.546
tissue healing that we see in pro sports,

00:13:09.566 --> 00:13:09.725
right?

00:13:09.746 --> 00:13:10.427
Like bone healing.

00:13:11.345 --> 00:13:12.485
Player has a bone injury.

00:13:12.504 --> 00:13:14.206
Hey, here's the timeline.

00:13:14.285 --> 00:13:16.446
Nobody seems to fight it.

00:13:17.306 --> 00:13:18.147
Soft tissue injury.

00:13:18.567 --> 00:13:19.366
Here's the timeline.

00:13:19.407 --> 00:13:20.246
And everybody's wondering

00:13:20.287 --> 00:13:21.506
how we can take a week here

00:13:21.567 --> 00:13:22.268
or two weeks here.

00:13:22.307 --> 00:13:23.067
How do we shorten it?

00:13:23.087 --> 00:13:23.508
And it's like,

00:13:24.227 --> 00:13:25.087
it's all still tissue

00:13:25.128 --> 00:13:26.028
healing at some point, right?

00:13:26.048 --> 00:13:28.109
Like we have to, to your point,

00:13:28.208 --> 00:13:30.009
respect what timelines of healing are.

00:13:30.649 --> 00:13:31.149
We're not going to

00:13:31.190 --> 00:13:32.909
necessarily change biology.

00:13:33.529 --> 00:13:34.730
The Adrian Peterson case

00:13:34.791 --> 00:13:37.030
will haunt performance

00:13:37.051 --> 00:13:37.951
therapists for the rest of

00:13:38.010 --> 00:13:39.851
our lives and careers because it's,

00:13:40.668 --> 00:13:42.791
Everybody wants to use that as the example,

00:13:42.850 --> 00:13:44.032
but it's really a gamble

00:13:44.111 --> 00:13:45.312
and a risk assessment.

00:13:45.352 --> 00:13:47.333
So in those moments that

00:13:48.033 --> 00:13:51.417
your objective criteria may not be met,

00:13:51.517 --> 00:13:52.937
but you have an athlete who is saying,

00:13:53.698 --> 00:13:55.259
I'm good, I'm ready to go,

00:13:55.559 --> 00:13:56.620
I'm ready to push.

00:13:57.260 --> 00:13:58.962
How do you personally assess risk?

00:13:59.003 --> 00:14:00.384
And then how do you explain

00:14:00.423 --> 00:14:02.125
that risk assessment to the

00:14:02.264 --> 00:14:03.645
athlete and what they may

00:14:03.686 --> 00:14:05.086
or may not be getting themselves into?

00:14:06.548 --> 00:14:07.688
Transparency and honesty.

00:14:07.708 --> 00:14:08.769
And I think

00:14:10.450 --> 00:14:12.192
I've learned over the years, if you try to,

00:14:12.471 --> 00:14:14.793
if I've tried to be too

00:14:14.894 --> 00:14:15.794
smart with how I'm trying

00:14:15.815 --> 00:14:16.855
to communicate or

00:14:17.476 --> 00:14:20.159
circumvent the truth of like, hey, again,

00:14:20.179 --> 00:14:21.301
sticking with the knee injured, hey,

00:14:21.321 --> 00:14:22.642
your quadriceps just not strong enough.

00:14:23.182 --> 00:14:24.062
And because your quadriceps

00:14:24.082 --> 00:14:24.703
not strong enough,

00:14:25.952 --> 00:14:26.812
not going to be able to jump

00:14:26.832 --> 00:14:27.852
or absorb forces as well

00:14:28.274 --> 00:14:29.374
you may use an alternative

00:14:29.394 --> 00:14:30.293
strategy you may be able to

00:14:30.333 --> 00:14:31.614
perform the test and get

00:14:31.634 --> 00:14:32.975
the outputs we need but

00:14:33.014 --> 00:14:33.855
it's not the same quality

00:14:34.634 --> 00:14:36.475
so I think to answer the

00:14:36.535 --> 00:14:38.395
question I've just come to

00:14:38.416 --> 00:14:38.936
a space of being

00:14:38.975 --> 00:14:39.936
transparent and honest at

00:14:39.956 --> 00:14:40.716
the end of the day it's not

00:14:40.736 --> 00:14:42.736
my decision ultimately as

00:14:42.777 --> 00:14:43.817
much as I may want it to be

00:14:43.836 --> 00:14:44.937
my decision as much as I

00:14:45.197 --> 00:14:46.817
think we have to respect

00:14:46.878 --> 00:14:49.019
what we do know I have come

00:14:49.078 --> 00:14:50.519
to learn and appreciate that

00:14:52.505 --> 00:14:53.326
the athlete probably going

00:14:53.346 --> 00:14:54.187
to make the final decision

00:14:55.326 --> 00:14:56.947
and they're going to listen to advice.

00:14:56.988 --> 00:14:59.729
They're going to take in the

00:14:59.828 --> 00:15:00.610
expert's opinions.

00:15:00.649 --> 00:15:03.010
They're going to understand

00:15:03.051 --> 00:15:04.030
and appreciate and trust

00:15:04.071 --> 00:15:05.471
those that are close to them, right?

00:15:05.491 --> 00:15:07.253
You can never discount that.

00:15:07.452 --> 00:15:09.673
But like the analogy I like to use is, um,

00:15:10.293 --> 00:15:11.575
there's so many things we

00:15:11.634 --> 00:15:13.134
know about health and

00:15:13.154 --> 00:15:14.416
performance that even you

00:15:14.456 --> 00:15:16.517
and I probably participate in.

00:15:16.537 --> 00:15:18.477
Let's just say, Hey, we, we have beers,

00:15:18.538 --> 00:15:18.717
right?

00:15:18.758 --> 00:15:19.958
We go out, go to the bar,

00:15:19.979 --> 00:15:20.678
we have a few beers.

00:15:21.139 --> 00:15:22.159
There's so much literature

00:15:22.179 --> 00:15:23.240
to suggest that alcohol in

00:15:23.341 --> 00:15:25.023
any form is bad for health.

00:15:25.863 --> 00:15:26.364
But we're still going to

00:15:26.384 --> 00:15:27.245
make the conscious decision

00:15:27.264 --> 00:15:27.904
to go have a beer.

00:15:28.225 --> 00:15:28.426
Right.

00:15:28.446 --> 00:15:29.346
So I think I try to

00:15:29.365 --> 00:15:31.128
extrapolate that and say, OK,

00:15:31.148 --> 00:15:31.869
this person has all the

00:15:31.889 --> 00:15:33.690
information at hand and

00:15:33.730 --> 00:15:35.052
we're advising this.

00:15:36.152 --> 00:15:37.413
This based on my experiences,

00:15:37.634 --> 00:15:38.475
based on the objective

00:15:38.495 --> 00:15:39.254
measures that I have,

00:15:39.735 --> 00:15:41.177
based on every other

00:15:41.317 --> 00:15:42.118
emotional experience.

00:15:43.115 --> 00:15:44.235
external factor that may be

00:15:44.294 --> 00:15:45.176
influencing decision.

00:15:45.655 --> 00:15:47.135
And you just have to appreciate, I think,

00:15:48.336 --> 00:15:49.937
we have to appreciate that

00:15:49.956 --> 00:15:51.118
it's a complex decision and

00:15:51.138 --> 00:15:53.177
we'll never have an absolutes.

00:15:53.698 --> 00:15:54.418
And when it comes to,

00:15:54.438 --> 00:15:55.339
I love hearing you say,

00:15:55.399 --> 00:15:56.919
talk about risk mitigation,

00:15:57.000 --> 00:15:57.820
risk versus reward.

00:15:58.279 --> 00:15:59.039
That's ultimately what the

00:15:59.100 --> 00:15:59.841
conversation is.

00:15:59.961 --> 00:16:02.381
And as sexy as that sounds

00:16:02.422 --> 00:16:04.501
to have risk mitigation

00:16:04.601 --> 00:16:05.722
percentage numbers and

00:16:06.982 --> 00:16:07.703
if you play this,

00:16:07.744 --> 00:16:10.027
you're five times more likely to get,

00:16:10.366 --> 00:16:11.327
we don't have those numbers

00:16:11.347 --> 00:16:12.788
because injuries are so complex.

00:16:13.009 --> 00:16:14.831
Humans are complex organisms.

00:16:15.292 --> 00:16:16.533
And especially in team sports,

00:16:16.594 --> 00:16:17.774
we're operating in chaotic

00:16:17.815 --> 00:16:19.376
systems that I'm not saying

00:16:19.397 --> 00:16:20.937
there's a right or wrong, or I'm saying,

00:16:20.977 --> 00:16:22.460
Hey, like there's nothing that works.

00:16:22.480 --> 00:16:23.041
There's definitely

00:16:23.081 --> 00:16:24.241
reasonable stuff that we know.

00:16:24.721 --> 00:16:26.163
I've just come to appreciate that.

00:16:27.544 --> 00:16:29.025
in those moments just be

00:16:29.066 --> 00:16:29.765
honest with what you

00:16:29.806 --> 00:16:31.547
believe in speak your mind

00:16:32.327 --> 00:16:33.327
they can agree or disagree

00:16:33.368 --> 00:16:33.967
it may not be what they

00:16:34.008 --> 00:16:36.789
want to hear and ultimately

00:16:36.809 --> 00:16:38.510
if it's not your body you

00:16:38.530 --> 00:16:39.110
probably don't have the

00:16:39.130 --> 00:16:42.832
final say yeah I appreciate

00:16:43.052 --> 00:16:44.714
your humility there and how

00:16:44.793 --> 00:16:47.414
big of an impact can you or

00:16:47.815 --> 00:16:49.076
I or any practitioner in

00:16:49.096 --> 00:16:50.517
pro sports truly have here

00:16:50.557 --> 00:16:52.518
that it's not about us um

00:16:53.794 --> 00:16:54.956
on an episode with Steve Short,

00:16:54.975 --> 00:16:55.995
who you know from the Nuggets,

00:16:56.275 --> 00:16:57.417
talked a little bit about that,

00:16:57.456 --> 00:16:58.876
about like we're a very

00:16:58.996 --> 00:17:00.118
small piece of the puzzle

00:17:00.778 --> 00:17:01.437
when it comes to an

00:17:01.518 --> 00:17:02.739
athlete's life and decision

00:17:02.798 --> 00:17:05.519
making and not overestimating that.

00:17:05.539 --> 00:17:07.800
So I think it's important to highlight,

00:17:07.840 --> 00:17:08.682
especially as you look

00:17:08.741 --> 00:17:09.821
across the progression of

00:17:09.882 --> 00:17:12.323
rehab and as more and more

00:17:12.383 --> 00:17:13.344
decision makers get

00:17:13.403 --> 00:17:15.585
involved as rehab advances,

00:17:15.904 --> 00:17:17.424
as they move along this continuum.

00:17:18.145 --> 00:17:19.125
I wanted to circle back to a

00:17:19.165 --> 00:17:21.106
piece you had and you were

00:17:21.146 --> 00:17:22.647
first talking about your rehab continuum.

00:17:23.626 --> 00:17:24.968
about the ball being

00:17:25.068 --> 00:17:26.289
included or having sports

00:17:26.309 --> 00:17:28.311
specific task included throughout.

00:17:28.432 --> 00:17:30.973
So can you speak to the integration of,

00:17:31.114 --> 00:17:32.576
you know, in the NBA, easy,

00:17:32.596 --> 00:17:33.817
like how do we integrate the ball?

00:17:33.876 --> 00:17:35.519
How do we integrate all the

00:17:35.558 --> 00:17:36.619
guys want to shoot, right?

00:17:36.660 --> 00:17:38.201
Like how do we integrate the

00:17:38.221 --> 00:17:39.162
ball early on?

00:17:39.442 --> 00:17:42.285
How does that kind of blend across rehab?

00:17:42.325 --> 00:17:42.705
Cause I think,

00:17:43.819 --> 00:17:45.380
It's very easy to say, hey,

00:17:45.400 --> 00:17:46.601
we're not doing anything,

00:17:46.661 --> 00:17:47.480
then we're running,

00:17:47.721 --> 00:17:49.101
then we're doing multi-directional work,

00:17:49.141 --> 00:17:50.721
then we're doing small-sided games,

00:17:50.781 --> 00:17:52.801
then non-contact and contact practice.

00:17:52.821 --> 00:17:54.481
But we both know, one,

00:17:54.521 --> 00:17:55.623
that's not the reality, and two,

00:17:55.663 --> 00:17:56.923
our athletes would go crazy

00:17:56.942 --> 00:17:57.843
if you took the ball away

00:17:57.863 --> 00:17:59.044
from them for that long and said, hey,

00:17:59.064 --> 00:17:59.884
for the next 12 weeks,

00:17:59.903 --> 00:18:00.703
you're going to do nothing.

00:18:02.023 --> 00:18:02.983
Can you speak to how you

00:18:03.023 --> 00:18:03.984
integrate that and how you

00:18:04.025 --> 00:18:04.805
blend this kind of

00:18:05.545 --> 00:18:07.464
performance sport component

00:18:07.684 --> 00:18:09.566
with rehab and training?

00:18:10.349 --> 00:18:10.789
Absolutely.

00:18:11.089 --> 00:18:13.551
And this goes back to having

00:18:13.571 --> 00:18:14.251
an understanding and

00:18:14.271 --> 00:18:16.053
appreciation of working in

00:18:16.093 --> 00:18:18.134
the areas of sports science

00:18:18.193 --> 00:18:19.355
and data early in my career,

00:18:19.515 --> 00:18:20.415
where like a big part of my

00:18:20.476 --> 00:18:22.757
job was we had this GPS

00:18:22.797 --> 00:18:23.416
system that I was

00:18:23.457 --> 00:18:24.597
responsible of tagging all

00:18:24.617 --> 00:18:25.979
the drills and looking at the

00:18:26.719 --> 00:18:27.660
physical outputs of the

00:18:27.700 --> 00:18:28.842
drills and understanding, okay,

00:18:28.862 --> 00:18:29.843
this drill does this,

00:18:29.942 --> 00:18:31.243
this type of game does this.

00:18:31.304 --> 00:18:32.546
If we open up the space,

00:18:32.726 --> 00:18:34.086
we get more high speed running.

00:18:34.146 --> 00:18:35.348
If we close down the space,

00:18:35.848 --> 00:18:36.890
we get more acceleration

00:18:36.950 --> 00:18:37.750
and decelerations.

00:18:38.211 --> 00:18:39.373
So having a perspective and

00:18:39.413 --> 00:18:40.294
appreciation for that.

00:18:40.354 --> 00:18:41.515
Now you don't have to work

00:18:42.175 --> 00:18:43.037
in a job like that.

00:18:43.096 --> 00:18:44.337
But there's definitely a lot

00:18:44.357 --> 00:18:46.980
of research out there, especially soccer,

00:18:47.161 --> 00:18:48.182
Aussie rules, football,

00:18:48.281 --> 00:18:51.125
rugby of people breaking down drills,

00:18:51.265 --> 00:18:52.806
breaking down game type,

00:18:52.846 --> 00:18:55.189
small sided games, and recognizing, hey,

00:18:55.229 --> 00:18:56.109
what are the physical

00:18:56.170 --> 00:18:58.211
demands that this drill is

00:18:59.132 --> 00:19:01.694
providing the athlete like a big,

00:19:03.336 --> 00:19:04.237
a big phrase you might hear

00:19:04.257 --> 00:19:05.578
in the soccer space or the

00:19:07.605 --> 00:19:09.406
rugby space is tactical periodization.

00:19:09.426 --> 00:19:10.606
I think, you know,

00:19:10.646 --> 00:19:12.147
Charlie Francis popularized

00:19:12.167 --> 00:19:14.148
the term vertical integration, right?

00:19:14.169 --> 00:19:14.949
These are just all these

00:19:15.009 --> 00:19:15.949
things that are just talking about,

00:19:15.989 --> 00:19:17.170
nothing operates in isolation.

00:19:17.190 --> 00:19:18.349
They're all part of one of the others,

00:19:18.390 --> 00:19:19.770
just understanding again,

00:19:19.810 --> 00:19:21.372
what's your intention and

00:19:21.471 --> 00:19:22.311
how do you want to

00:19:22.451 --> 00:19:23.392
implement that intention?

00:19:23.771 --> 00:19:24.173
So to,

00:19:24.532 --> 00:19:26.073
I share that perspective just to

00:19:26.232 --> 00:19:27.314
open it up saying, Hey,

00:19:27.894 --> 00:19:29.494
it's not that hard.

00:19:29.954 --> 00:19:31.095
You just have to pull back.

00:19:31.174 --> 00:19:32.496
What is the activity that you,

00:19:32.516 --> 00:19:33.316
or what is the athletic

00:19:33.375 --> 00:19:34.757
quality that you're trying to get out of?

00:19:35.257 --> 00:19:36.037
And is that something that

00:19:36.076 --> 00:19:37.738
you can do with the ball in the hand,

00:19:37.758 --> 00:19:38.377
ball, the feet,

00:19:38.798 --> 00:19:39.878
or is that something you really have to,

00:19:39.919 --> 00:19:40.038
Hey,

00:19:40.058 --> 00:19:40.959
we just got to work in this in

00:19:41.058 --> 00:19:41.900
isolation because the

00:19:41.960 --> 00:19:42.980
quality that really is only

00:19:43.019 --> 00:19:44.280
going to happen if we work

00:19:44.300 --> 00:19:45.280
it out in isolation, right?

00:19:45.320 --> 00:19:46.300
Like you're only going to

00:19:46.342 --> 00:19:47.422
strengthen a quad and a

00:19:47.481 --> 00:19:49.323
high level with open chain

00:19:49.343 --> 00:19:50.563
knee exercises or closed

00:19:50.603 --> 00:19:51.864
chain single leg exercises, right?

00:19:51.884 --> 00:19:53.284
You can't skip those things.

00:19:53.304 --> 00:19:54.525
So that's just understand, okay,

00:19:54.545 --> 00:19:55.065
this is what I need.

00:19:55.085 --> 00:19:55.865
This is what I got to do.

00:19:56.365 --> 00:19:57.405
So to your question about

00:19:57.486 --> 00:19:58.886
how do I integrate it with sport?

00:19:58.906 --> 00:19:59.886
I think the easiest example

00:19:59.926 --> 00:20:01.007
we can all kind of wrap our

00:20:01.047 --> 00:20:01.548
heads around is

00:20:03.325 --> 00:20:04.665
We all have our jumping progressions.

00:20:05.046 --> 00:20:06.426
We all have our running progressions,

00:20:06.846 --> 00:20:07.008
right?

00:20:07.468 --> 00:20:08.288
Something in the sport of

00:20:08.307 --> 00:20:10.190
basketball that is a

00:20:10.250 --> 00:20:12.651
progression of those is the jump shot,

00:20:12.932 --> 00:20:15.413
which is a low intensity,

00:20:16.013 --> 00:20:17.914
extensive plyometric, right?

00:20:18.035 --> 00:20:19.296
Extensive versus intensive.

00:20:19.375 --> 00:20:20.017
Extensive being...

00:20:20.817 --> 00:20:22.198
long duration ground contact

00:20:22.238 --> 00:20:24.057
times intensive being short

00:20:24.097 --> 00:20:25.058
duration ground contact

00:20:25.078 --> 00:20:26.038
times like sprinting or

00:20:26.058 --> 00:20:27.380
going up for a dump but a

00:20:27.460 --> 00:20:29.300
simple jump shot is if you

00:20:29.320 --> 00:20:31.381
hit 50 jump shots that's 50

00:20:31.381 --> 00:20:33.102
extensive low intensity

00:20:33.142 --> 00:20:34.843
aerobic plyos so I look at

00:20:34.883 --> 00:20:35.863
in a sense well if I can if

00:20:35.903 --> 00:20:36.864
I look at a jump shot and

00:20:36.903 --> 00:20:38.564
use that example what other

00:20:38.644 --> 00:20:40.444
activities are synonymous

00:20:40.505 --> 00:20:41.905
with things that aren't

00:20:42.006 --> 00:20:43.125
with the ball in hand so

00:20:43.145 --> 00:20:44.866
you know a classic warm-up

00:20:44.906 --> 00:20:45.626
drill that I see a lot of

00:20:45.666 --> 00:20:46.948
basketball players do is you

00:20:47.627 --> 00:20:48.167
they'll start at the

00:20:48.209 --> 00:20:49.449
baseline and they'll just

00:20:49.490 --> 00:20:51.090
do walking ball handling up

00:20:51.171 --> 00:20:51.770
to half court.

00:20:52.011 --> 00:20:53.051
And they'll do walking ball

00:20:53.071 --> 00:20:55.074
handling back to, back to baseline.

00:20:55.473 --> 00:20:56.375
And then they might do it

00:20:56.434 --> 00:20:59.037
where it's lots of, man,

00:20:59.057 --> 00:21:00.498
my basketball angle crossovers,

00:21:00.637 --> 00:21:01.519
or they'll,

00:21:01.538 --> 00:21:02.539
they'll put the ball through their legs.

00:21:02.579 --> 00:21:02.720
Right.

00:21:02.759 --> 00:21:03.560
And they'll, and they'll,

00:21:03.641 --> 00:21:04.280
they'll start changing

00:21:04.300 --> 00:21:05.761
direction in small spaces.

00:21:06.002 --> 00:21:06.682
So I'm like, Ooh, okay.

00:21:06.702 --> 00:21:08.845
Like as I'm watching them do these things,

00:21:08.884 --> 00:21:10.046
like in a non injured state

00:21:10.066 --> 00:21:11.307
and a non rehabs, I'm like, okay, like,

00:21:11.846 --> 00:21:14.067
cool like they just did 20

00:21:14.067 --> 00:21:14.907
minutes of jump shooting

00:21:14.928 --> 00:21:15.729
that's a 20 minute

00:21:15.749 --> 00:21:17.108
extensive plyometric

00:21:17.128 --> 00:21:18.950
workout I when I get to an

00:21:18.990 --> 00:21:19.730
athlete and think hey I

00:21:19.750 --> 00:21:21.530
think you can do extensive

00:21:21.570 --> 00:21:23.112
plyos rather than putting

00:21:23.132 --> 00:21:24.211
them in the weight room and

00:21:24.251 --> 00:21:25.712
just jump roping them or

00:21:26.173 --> 00:21:27.614
just doing those soft plyos

00:21:27.653 --> 00:21:29.034
back and forth cool go out

00:21:29.054 --> 00:21:30.234
and shoot 50 jump shots man

00:21:30.355 --> 00:21:32.016
go out and just stationary

00:21:32.316 --> 00:21:33.336
be a part because I know

00:21:33.375 --> 00:21:34.436
like that's the same exact

00:21:34.477 --> 00:21:35.277
stimulus that I would

00:21:35.297 --> 00:21:37.117
provide you in the weight room

00:21:37.753 --> 00:21:38.557
the ball handling,

00:21:38.616 --> 00:21:39.319
if I'm starting to do

00:21:39.380 --> 00:21:42.009
introduction to change a direction, well,

00:21:42.028 --> 00:21:42.770
if I just have a

00:21:42.811 --> 00:21:44.215
conversation with a coach and say, hey,

00:21:45.108 --> 00:21:46.229
This is what I need out of him.

00:21:46.328 --> 00:21:47.470
We're trying to get just low

00:21:47.509 --> 00:21:48.829
intensity changes of direction.

00:21:48.890 --> 00:21:50.549
So, and most of the time,

00:21:50.589 --> 00:21:51.690
if you just break it down,

00:21:51.730 --> 00:21:52.830
these coaches are brilliant.

00:21:52.851 --> 00:21:53.990
They understand like they're

00:21:54.111 --> 00:21:55.330
so creative that they come

00:21:55.371 --> 00:21:56.692
up with things that you

00:21:56.711 --> 00:21:57.491
wouldn't even think of.

00:21:57.592 --> 00:21:59.791
And in actuality, it's more specific,

00:21:59.852 --> 00:21:59.991
right?

00:22:00.011 --> 00:22:01.573
We talk about sports specificity.

00:22:02.032 --> 00:22:03.272
I think one thing we have to

00:22:03.333 --> 00:22:05.032
do better as an industry is

00:22:05.452 --> 00:22:06.854
educate and trust our coaches.

00:22:07.314 --> 00:22:08.874
And when I say educate them, I mean,

00:22:08.953 --> 00:22:09.753
taking the time to

00:22:09.794 --> 00:22:10.855
communicate what it is that

00:22:10.894 --> 00:22:12.115
you want physically and

00:22:12.694 --> 00:22:15.156
and then allowing them to

00:22:15.196 --> 00:22:16.357
have space to create

00:22:16.458 --> 00:22:17.199
because that's what coaches

00:22:17.219 --> 00:22:17.699
are great at doing.

00:22:17.858 --> 00:22:18.799
They're great at creating

00:22:19.240 --> 00:22:20.080
and they're great at

00:22:20.141 --> 00:22:20.922
connecting with the player.

00:22:21.221 --> 00:22:22.063
Probably better than some of

00:22:22.143 --> 00:22:22.803
us are just because of the

00:22:22.823 --> 00:22:23.483
sheer fact that they're a

00:22:23.523 --> 00:22:24.765
sport coach and we're not, right?

00:22:24.785 --> 00:22:25.826
Like I wouldn't trust me to

00:22:25.865 --> 00:22:26.625
tell you how to take a jump

00:22:26.645 --> 00:22:27.946
shot or put you through a

00:22:27.987 --> 00:22:28.768
basketball workout,

00:22:28.807 --> 00:22:29.909
but I develop a

00:22:29.929 --> 00:22:30.568
relationship with two or

00:22:30.588 --> 00:22:32.171
three of my assistant coaches like, man,

00:22:32.891 --> 00:22:33.912
Now, like indirectly,

00:22:34.311 --> 00:22:35.192
I'm helping this athlete,

00:22:35.212 --> 00:22:36.173
but it doesn't have to be me.

00:22:36.353 --> 00:22:38.555
And I think that's where my mind goes.

00:22:38.595 --> 00:22:39.675
I hope I'm answering this question.

00:22:39.715 --> 00:22:41.297
I may have gone around in circles here,

00:22:41.336 --> 00:22:42.156
but I think to bring it

00:22:42.217 --> 00:22:43.238
back full circle to your

00:22:43.258 --> 00:22:43.998
original question,

00:22:44.439 --> 00:22:45.980
when it comes to integrating the sport,

00:22:46.619 --> 00:22:47.000
to me,

00:22:47.039 --> 00:22:49.041
it's not standing on a foam pad and

00:22:49.182 --> 00:22:50.281
catching a basketball and

00:22:50.301 --> 00:22:51.303
working on single leg balance.

00:22:51.363 --> 00:22:51.782
It's not...

00:22:53.268 --> 00:22:54.209
Standing in the in the

00:22:54.249 --> 00:22:55.390
training room and working

00:22:55.529 --> 00:22:56.951
on little volleys if you're

00:22:56.971 --> 00:22:57.751
a soccer player, right?

00:22:57.832 --> 00:22:59.053
I think it's a matter of how

00:22:59.073 --> 00:23:00.493
do you understand what the

00:23:00.554 --> 00:23:01.615
sport demands are?

00:23:02.174 --> 00:23:03.536
understand what you want

00:23:03.736 --> 00:23:05.178
physically maybe even

00:23:05.238 --> 00:23:06.798
mentally as well because don't forget I

00:23:07.346 --> 00:23:08.346
The moment the athlete gets

00:23:08.386 --> 00:23:09.188
back on the field or the

00:23:09.228 --> 00:23:10.407
court and they're working with the coach,

00:23:10.907 --> 00:23:11.449
they can exhale.

00:23:11.469 --> 00:23:12.628
They're getting closer, right?

00:23:12.669 --> 00:23:13.348
If you're trying to do

00:23:13.449 --> 00:23:15.069
everything in isolation, again,

00:23:15.289 --> 00:23:16.650
sometimes you do need that.

00:23:16.690 --> 00:23:17.810
Don't lose sight of that.

00:23:17.851 --> 00:23:18.750
Please don't lose sight of, hey,

00:23:19.211 --> 00:23:20.451
there are moments where it's like, hey,

00:23:20.471 --> 00:23:21.271
I need you off the court

00:23:21.291 --> 00:23:22.432
because I don't want eyes on this.

00:23:22.913 --> 00:23:23.932
I want us to trial through

00:23:23.952 --> 00:23:24.573
this and work through this

00:23:24.633 --> 00:23:25.452
ourselves because, hey,

00:23:25.472 --> 00:23:26.413
this is something new for you.

00:23:26.433 --> 00:23:27.433
We haven't done this in a while.

00:23:27.753 --> 00:23:28.515
And that's an important

00:23:28.535 --> 00:23:29.454
space to recognize too.

00:23:30.015 --> 00:23:30.615
But I promise you,

00:23:30.635 --> 00:23:32.478
if we can peel back what

00:23:32.518 --> 00:23:33.999
the actual sport action is,

00:23:34.559 --> 00:23:36.020
understand what it's doing physically,

00:23:36.080 --> 00:23:36.221
right?

00:23:36.260 --> 00:23:37.782
Dive into some of the research in rugby,

00:23:37.823 --> 00:23:38.943
dive into some of the research.

00:23:39.243 --> 00:23:40.105
Even basketball is doing a

00:23:40.144 --> 00:23:40.665
pretty good job.

00:23:40.685 --> 00:23:41.586
Some of the European leagues

00:23:41.605 --> 00:23:42.527
are looking at small sided

00:23:42.547 --> 00:23:43.709
games over there is

00:23:43.848 --> 00:23:44.689
understanding what the

00:23:44.809 --> 00:23:45.830
physical demands are.

00:23:46.471 --> 00:23:47.471
and then getting creative

00:23:47.490 --> 00:23:48.471
with your rehab program to

00:23:48.511 --> 00:23:50.031
say hey do I have to be the

00:23:50.071 --> 00:23:51.071
person that implements this

00:23:51.432 --> 00:23:52.532
and saying this on the

00:23:52.593 --> 00:23:53.732
context of you work in team

00:23:53.772 --> 00:23:54.613
sports and you have access

00:23:54.633 --> 00:23:55.932
to this if you don't then

00:23:55.952 --> 00:23:57.693
by all means keep doing

00:23:57.713 --> 00:23:59.273
what you're doing of what I

00:23:59.334 --> 00:24:00.315
refer to in isolation

00:24:00.355 --> 00:24:01.494
meaning not on the court

00:24:01.595 --> 00:24:02.474
not on the field like keep

00:24:02.515 --> 00:24:03.255
doing what you have to do

00:24:03.315 --> 00:24:04.435
to build those general

00:24:04.476 --> 00:24:05.675
qualities so that when they

00:24:05.756 --> 00:24:06.935
do go to team practice or

00:24:06.955 --> 00:24:08.717
they do go work on an

00:24:08.777 --> 00:24:09.757
individual session without

00:24:09.797 --> 00:24:10.497
you there you feel

00:24:10.557 --> 00:24:11.376
comfortable and confident

00:24:11.416 --> 00:24:12.557
saying hey I at least know

00:24:12.597 --> 00:24:13.377
you can do these things

00:24:15.573 --> 00:24:16.638
Man, that is...

00:24:18.584 --> 00:24:19.903
not just sprinkling gold on

00:24:19.923 --> 00:24:20.845
top of something that is

00:24:20.924 --> 00:24:22.164
that is pure gold which you

00:24:22.184 --> 00:24:24.026
just uh discussed and maybe

00:24:24.066 --> 00:24:25.445
it's because I'm

00:24:25.746 --> 00:24:26.946
significantly biased and I

00:24:27.007 --> 00:24:28.946
agree with you on on all of

00:24:29.027 --> 00:24:30.807
it I i think educating

00:24:30.907 --> 00:24:32.087
coaches in this space is

00:24:32.147 --> 00:24:34.848
such a home run and in not

00:24:34.949 --> 00:24:36.069
trying to be the guy that

00:24:36.109 --> 00:24:37.789
does it all like it it

00:24:37.829 --> 00:24:39.230
doesn't matter who does it

00:24:39.651 --> 00:24:40.411
it matters what the

00:24:40.471 --> 00:24:41.631
stimulus to your point is

00:24:41.671 --> 00:24:42.791
what is the stimulus on the

00:24:42.892 --> 00:24:44.852
athlete and are we moving

00:24:44.912 --> 00:24:46.813
in a positive direction in their rehab so

00:24:47.958 --> 00:24:49.480
Educating coaches to me is huge.

00:24:49.519 --> 00:24:50.941
And I think probably

00:24:51.181 --> 00:24:53.163
underappreciated because we

00:24:53.202 --> 00:24:56.926
become very fearful in this space of,

00:24:57.847 --> 00:24:59.148
is it safe for somebody to do it?

00:24:59.189 --> 00:24:59.789
That's not me.

00:24:59.809 --> 00:25:00.769
Are they going to appreciate

00:25:00.789 --> 00:25:01.691
the movement like I am?

00:25:01.711 --> 00:25:02.291
And they're probably going

00:25:02.311 --> 00:25:02.972
to appreciate it better

00:25:02.992 --> 00:25:04.433
because they've watched more jump shots.

00:25:04.453 --> 00:25:05.454
They've spent more time

00:25:05.555 --> 00:25:06.455
coaching that movement.

00:25:06.496 --> 00:25:07.497
I've had coaches come up to

00:25:07.517 --> 00:25:09.719
me and been very clear with like,

00:25:10.599 --> 00:25:11.921
something's off with his left leg.

00:25:12.000 --> 00:25:12.321
And you're like,

00:25:13.835 --> 00:25:14.516
put them on the force plate

00:25:14.536 --> 00:25:16.416
and you're like, holy cow, he was right.

00:25:16.817 --> 00:25:17.498
That's incredible.

00:25:17.938 --> 00:25:19.159
But they've seen it so much

00:25:19.199 --> 00:25:19.898
more than we have and

00:25:19.919 --> 00:25:21.099
they've coached that same

00:25:21.160 --> 00:25:22.381
movement over and over again.

00:25:22.401 --> 00:25:24.502
So to branch off of that a

00:25:24.563 --> 00:25:26.023
little bit and move away

00:25:26.084 --> 00:25:28.045
from the pure rehab discussion,

00:25:28.125 --> 00:25:29.526
can you speak to

00:25:29.766 --> 00:25:31.067
interdisciplinary practice

00:25:31.267 --> 00:25:32.488
across the continuum?

00:25:32.528 --> 00:25:35.250
You have the bias of you

00:25:35.269 --> 00:25:37.211
were a fitness coach into

00:25:37.251 --> 00:25:38.372
the sports science space,

00:25:38.413 --> 00:25:39.393
into the PT space.

00:25:39.432 --> 00:25:41.255
So you stretch many of these

00:25:41.335 --> 00:25:42.816
roles that are involved, but

00:25:43.717 --> 00:25:45.817
For listeners that may only be PTs,

00:25:47.218 --> 00:25:48.598
how does interdisciplinary

00:25:48.618 --> 00:25:51.799
practice work in the NBA from PT,

00:25:51.880 --> 00:25:54.701
strength coach, AT, position coaches?

00:25:54.780 --> 00:25:55.921
Can you speak to that

00:25:56.060 --> 00:25:57.362
progression and how that works?

00:25:58.968 --> 00:26:00.128
It's a really good question.

00:26:00.169 --> 00:26:01.509
That's where I think teams

00:26:01.631 --> 00:26:02.811
are successful or not

00:26:02.852 --> 00:26:04.333
successful is how well they

00:26:04.373 --> 00:26:05.413
can manage that.

00:26:05.433 --> 00:26:06.694
Because ultimately,

00:26:07.296 --> 00:26:08.196
we have to have a respect

00:26:08.237 --> 00:26:09.798
that everybody just wants to be important,

00:26:09.817 --> 00:26:09.917
right?

00:26:09.938 --> 00:26:10.538
This is just people.

00:26:10.798 --> 00:26:11.660
People want to feel valued.

00:26:11.680 --> 00:26:12.461
People want to be heard.

00:26:12.480 --> 00:26:13.402
People want to feel important.

00:26:13.442 --> 00:26:14.261
They want to be included.

00:26:14.782 --> 00:26:15.343
And I think...

00:26:16.084 --> 00:26:17.284
I've lost sight of that in my career.

00:26:17.304 --> 00:26:18.704
It's like, oh, like my head's down.

00:26:18.744 --> 00:26:19.884
I know how to do this, this, this.

00:26:19.904 --> 00:26:20.585
But like you said,

00:26:20.605 --> 00:26:22.105
like I've kind of spent my

00:26:22.165 --> 00:26:23.346
time across that continuum

00:26:23.365 --> 00:26:24.186
with the exception of like

00:26:24.247 --> 00:26:25.186
acute medical care.

00:26:26.267 --> 00:26:27.627
But from a therapy to

00:26:28.228 --> 00:26:29.688
training to sports science,

00:26:29.768 --> 00:26:30.949
even being a sport coach, right?

00:26:30.969 --> 00:26:31.848
Like I was even a college

00:26:31.868 --> 00:26:33.029
soccer coach early in my career.

00:26:33.049 --> 00:26:33.930
So I have an appreciation

00:26:33.970 --> 00:26:35.509
for what it's like to plan

00:26:35.529 --> 00:26:37.050
for a season and run a training session.

00:26:37.770 --> 00:26:38.411
So yes,

00:26:38.431 --> 00:26:40.872
like I've been at fault myself of

00:26:42.291 --> 00:26:43.932
trying to do it all and not

00:26:44.012 --> 00:26:45.153
leaning on my teammates

00:26:45.192 --> 00:26:46.993
that can maybe do some of that as well.

00:26:47.253 --> 00:26:48.134
Because inevitably what's

00:26:48.153 --> 00:26:48.913
going to happen is you're

00:26:48.933 --> 00:26:49.634
going to get to a point in

00:26:49.653 --> 00:26:50.714
the season or a point in

00:26:51.275 --> 00:26:52.694
time where you can't do it

00:26:52.714 --> 00:26:53.815
all because your caseload is too big.

00:26:53.875 --> 00:26:54.496
And now you're going to go

00:26:54.516 --> 00:26:55.476
to the people asking for help.

00:26:55.536 --> 00:26:55.955
And it's like,

00:26:56.875 --> 00:26:57.615
remember that time you tried

00:26:57.635 --> 00:26:58.336
doing it all by yourself?

00:26:58.376 --> 00:26:58.997
Why can't you do it now?

00:26:59.743 --> 00:27:00.525
And so I've run into those

00:27:00.565 --> 00:27:01.664
situations and I felt that

00:27:01.785 --> 00:27:04.126
and I've owned it in the past.

00:27:04.287 --> 00:27:05.807
So to your point of how do

00:27:05.847 --> 00:27:07.749
you manage it is first you

00:27:07.769 --> 00:27:09.650
got to manage yourself and

00:27:09.750 --> 00:27:11.391
understand what you're really good at.

00:27:11.471 --> 00:27:12.692
Like if you could pick one

00:27:12.731 --> 00:27:13.932
thing that you're damn good at,

00:27:14.693 --> 00:27:15.814
what is that one thing going to be?

00:27:16.255 --> 00:27:17.394
And then look at your teammates and ask,

00:27:17.454 --> 00:27:17.915
okay, cool.

00:27:18.988 --> 00:27:20.249
there's something else part of rehab.

00:27:20.269 --> 00:27:21.189
Like I could do that,

00:27:21.628 --> 00:27:22.388
but is there someone else

00:27:22.409 --> 00:27:23.769
that's the best at that on staff?

00:27:24.029 --> 00:27:25.111
And recognizing and being

00:27:25.171 --> 00:27:26.750
willing to give that

00:27:26.830 --> 00:27:28.811
opportunity to others and

00:27:28.912 --> 00:27:29.771
share their responsibility,

00:27:29.791 --> 00:27:30.393
because ultimately that's

00:27:30.413 --> 00:27:31.133
what's gonna make the team

00:27:31.173 --> 00:27:32.012
successful is just sharing

00:27:32.032 --> 00:27:35.335
responsibilities and recognizing that

00:27:36.275 --> 00:27:37.096
it takes a village.

00:27:37.435 --> 00:27:38.356
Everybody wants to be included.

00:27:38.397 --> 00:27:39.318
Everybody just wants to help.

00:27:39.519 --> 00:27:40.160
That's the biggest thing.

00:27:40.240 --> 00:27:41.121
Everybody just wants to help

00:27:41.161 --> 00:27:41.641
these athletes.

00:27:41.661 --> 00:27:41.981
That's like,

00:27:42.201 --> 00:27:43.403
it's why we're all in this space.

00:27:43.423 --> 00:27:43.824
If we weren't,

00:27:44.183 --> 00:27:45.464
if we didn't care and didn't want to help,

00:27:45.484 --> 00:27:46.125
we wouldn't be in that

00:27:46.165 --> 00:27:47.667
space because the late

00:27:47.728 --> 00:27:48.888
nights and the travel is not worth it.

00:27:48.929 --> 00:27:49.130
Right.

00:27:50.631 --> 00:27:52.993
So just reflecting here and

00:27:53.013 --> 00:27:56.037
thinking you manage it by, by,

00:27:57.344 --> 00:27:58.305
understanding strengths,

00:27:58.505 --> 00:27:59.605
understanding what you're good at,

00:27:59.746 --> 00:28:00.967
understanding where other

00:28:00.987 --> 00:28:01.667
people are good at,

00:28:01.708 --> 00:28:02.728
but then also having a

00:28:02.788 --> 00:28:03.929
clear system and process

00:28:03.989 --> 00:28:05.330
because that's how people communicate.

00:28:06.270 --> 00:28:09.094
And I do a very poor job at

00:28:09.134 --> 00:28:11.154
times of what's going on in my head,

00:28:11.695 --> 00:28:13.116
not necessarily putting it on paper.

00:28:13.176 --> 00:28:14.617
Cause I'm just like in my mind, I'm like,

00:28:14.678 --> 00:28:15.759
okay, like that, that, that, that, okay,

00:28:15.778 --> 00:28:16.619
this is where we got to go today.

00:28:17.180 --> 00:28:18.441
But I think the analogy I've

00:28:18.461 --> 00:28:19.642
heard some colleagues say is like,

00:28:19.682 --> 00:28:20.583
if you weren't here today,

00:28:20.623 --> 00:28:21.503
like what would we do?

00:28:21.983 --> 00:28:23.644
And so just getting in a better space of,

00:28:23.664 --> 00:28:23.704
um,

00:28:24.719 --> 00:28:26.260
here is the trajectory of

00:28:26.300 --> 00:28:27.781
the path from start to finish.

00:28:27.862 --> 00:28:28.903
Almost like kind of how

00:28:30.325 --> 00:28:32.227
physical therapists do and surgeons,

00:28:32.346 --> 00:28:32.487
right?

00:28:32.507 --> 00:28:33.669
They've kind of map out what

00:28:33.709 --> 00:28:35.190
a nine month ACL rehab is

00:28:35.210 --> 00:28:35.750
going to look like.

00:28:36.191 --> 00:28:37.893
I think having some

00:28:37.992 --> 00:28:39.255
semblance of idea of what a

00:28:39.375 --> 00:28:40.496
general return to play

00:28:40.536 --> 00:28:41.596
process is going to look like.

00:28:41.717 --> 00:28:42.817
And then that allows the,

00:28:44.194 --> 00:28:45.576
creativity and autonomy from

00:28:45.615 --> 00:28:46.616
practitioner practitioner

00:28:46.636 --> 00:28:47.518
to at least accomplish the

00:28:47.538 --> 00:28:48.818
goal right if the goal is I

00:28:50.319 --> 00:28:51.240
can remember in the past

00:28:51.280 --> 00:28:52.142
you know hey we need to

00:28:52.182 --> 00:28:54.262
work on eccentric qualities

00:28:54.303 --> 00:28:55.403
and deceleration qualities

00:28:56.164 --> 00:28:57.105
you got a lot of talented

00:28:57.125 --> 00:28:57.965
coaches and therapists that

00:28:57.986 --> 00:28:59.768
can probably manage that

00:28:59.768 --> 00:29:01.409
101 different ways and

00:29:01.489 --> 00:29:03.191
recognizing that just

00:29:03.230 --> 00:29:04.290
because it's not your way

00:29:04.330 --> 00:29:04.971
or just because it's not

00:29:04.991 --> 00:29:06.292
the way I would do it you

00:29:06.313 --> 00:29:08.154
know I had one friend and mentor say

00:29:08.154 --> 00:29:10.022
80% of what we're all doing

00:29:10.042 --> 00:29:10.663
is the same stuff.

00:29:10.824 --> 00:29:11.785
The 20% is just like the

00:29:11.865 --> 00:29:13.146
autonomy and individuality

00:29:13.366 --> 00:29:14.167
of what we do and what we

00:29:14.208 --> 00:29:14.729
believe in from a

00:29:14.769 --> 00:29:15.849
creativity perspective that

00:29:15.869 --> 00:29:16.871
allows us to have ownership

00:29:16.911 --> 00:29:17.511
over what we do.

00:29:17.952 --> 00:29:18.894
But the reality is we're

00:29:19.193 --> 00:29:20.015
kind of all doing a lot of

00:29:20.035 --> 00:29:20.635
the same stuff.

00:29:21.217 --> 00:29:22.298
So just recognizing, okay,

00:29:22.317 --> 00:29:23.358
if that's the terminal goal

00:29:23.598 --> 00:29:25.181
of staying with this idea

00:29:25.201 --> 00:29:28.365
of eccentric qualities or deceleration,

00:29:29.346 --> 00:29:30.606
communicate that to whoever

00:29:30.646 --> 00:29:32.307
else is involved and just

00:29:32.347 --> 00:29:33.729
observe and then test and retest.

00:29:33.749 --> 00:29:34.809
Like you're going to use the same test.

00:29:34.829 --> 00:29:35.470
Okay.

00:29:35.550 --> 00:29:36.290
I may have done this,

00:29:36.611 --> 00:29:37.451
but you did it that way,

00:29:37.571 --> 00:29:38.972
but the test gave us the same output.

00:29:39.192 --> 00:29:39.413
Great.

00:29:39.553 --> 00:29:40.493
We're doing, we're on the right target.

00:29:40.894 --> 00:29:41.894
It also gives variability

00:29:41.914 --> 00:29:42.375
for the athletes.

00:29:42.434 --> 00:29:43.876
If you see them every day, right?

00:29:43.916 --> 00:29:44.817
Sometimes doing the same

00:29:44.856 --> 00:29:45.718
thing with you over and

00:29:45.778 --> 00:29:47.058
over just gets monotonous and boring.

00:29:47.138 --> 00:29:47.739
You throw in a new

00:29:47.778 --> 00:29:49.220
practitioner that chasing

00:29:49.240 --> 00:29:49.881
the same quality,

00:29:49.921 --> 00:29:51.362
but has six different

00:29:51.402 --> 00:29:52.702
exercises that they would

00:29:52.722 --> 00:29:53.644
do differently than you would.

00:29:54.104 --> 00:29:54.324
Great.

00:29:54.364 --> 00:29:55.164
Now it's a fresh start.

00:29:55.204 --> 00:29:56.065
It looks like progression.

00:29:56.144 --> 00:29:57.125
It looks like we're doing,

00:29:57.145 --> 00:29:58.166
we're moving the needle forward.

00:29:58.186 --> 00:29:58.227
Um,

00:29:58.807 --> 00:29:59.186
So I hope,

00:29:59.207 --> 00:30:00.728
I hope that answers your question.

00:30:00.748 --> 00:30:02.828
Um, as far as how you manage it,

00:30:02.848 --> 00:30:03.548
I think it's a,

00:30:04.630 --> 00:30:05.750
I will summarize and say

00:30:05.849 --> 00:30:08.531
open communication, honesty with yourself,

00:30:08.571 --> 00:30:09.152
what you're really,

00:30:09.192 --> 00:30:10.212
really good at and being

00:30:10.633 --> 00:30:11.732
willing to share the

00:30:11.752 --> 00:30:13.854
responsibility and then

00:30:14.894 --> 00:30:16.675
having a clear goal, excuse me,

00:30:16.695 --> 00:30:18.695
a clear goal in mind so that people know,

00:30:18.717 --> 00:30:19.836
okay, if this is the goal,

00:30:19.876 --> 00:30:20.998
I know how to execute this goal.

00:30:23.358 --> 00:30:23.538
Yeah.

00:30:23.858 --> 00:30:23.919
Uh,

00:30:25.196 --> 00:30:26.497
I think, again,

00:30:26.557 --> 00:30:28.077
there's so many good things there.

00:30:28.377 --> 00:30:29.298
The number one thing that I

00:30:29.337 --> 00:30:30.077
think for listeners to

00:30:30.118 --> 00:30:32.179
recognize that at no point

00:30:32.219 --> 00:30:33.619
there did Adam mentioned,

00:30:34.460 --> 00:30:35.500
this is the time I pass it

00:30:35.539 --> 00:30:36.440
off to the strength coach.

00:30:37.221 --> 00:30:39.101
This is the time I pass it off to the AT.

00:30:39.401 --> 00:30:43.301
It wasn't role driven or education,

00:30:43.342 --> 00:30:44.742
like previous education driven.

00:30:44.782 --> 00:30:44.982
It was

00:30:45.992 --> 00:30:47.692
very much who has the skill

00:30:47.732 --> 00:30:49.634
set at this time to do the

00:30:49.673 --> 00:30:53.174
task and very personal reflection.

00:30:53.255 --> 00:30:54.615
Cause it is so easy to just,

00:30:54.795 --> 00:30:56.955
I have been guilty of it many times.

00:30:56.976 --> 00:30:57.476
Like you said,

00:30:57.496 --> 00:30:58.736
I'm just like putting my head down,

00:30:58.796 --> 00:31:00.236
not writing things down on paper.

00:31:00.296 --> 00:31:01.416
I'm just going to go and do it.

00:31:01.957 --> 00:31:03.696
Um, but it doesn't,

00:31:03.777 --> 00:31:05.317
that doesn't lead to a successful team.

00:31:05.417 --> 00:31:08.377
So recognizing in yourself and others,

00:31:08.458 --> 00:31:10.479
regardless of credentialing, you know,

00:31:10.538 --> 00:31:12.318
who has the best skill set to execute.

00:31:12.358 --> 00:31:12.739
This is a,

00:31:13.539 --> 00:31:15.059
is a home run way to approach it.

00:31:15.400 --> 00:31:15.460
And.

00:31:16.613 --> 00:31:17.113
Off of that,

00:31:17.353 --> 00:31:19.835
I think continuing to move forward,

00:31:19.894 --> 00:31:22.516
as you get out of this kind

00:31:22.557 --> 00:31:23.797
of pure rehab space,

00:31:23.856 --> 00:31:24.938
players are back on the floor.

00:31:24.978 --> 00:31:26.239
You mentioned technology.

00:31:26.278 --> 00:31:27.960
You mentioned at one point AI.

00:31:29.279 --> 00:31:30.361
There's a huge influx of

00:31:30.381 --> 00:31:31.602
technology into the NBA.

00:31:31.682 --> 00:31:32.701
There's a huge influx in

00:31:32.741 --> 00:31:33.942
research in basketball

00:31:34.542 --> 00:31:35.804
internationally at this point.

00:31:35.824 --> 00:31:38.365
But what is your take on the

00:31:38.385 --> 00:31:40.007
integration of technology in the NBA?

00:31:40.047 --> 00:31:41.307
How do you blend this kind

00:31:41.346 --> 00:31:43.568
of art of rehab and this very...

00:31:44.413 --> 00:31:47.176
kind of strict, rigid sports science space,

00:31:47.237 --> 00:31:48.397
technology space where

00:31:48.438 --> 00:31:49.159
companies are saying,

00:31:49.239 --> 00:31:50.901
this is X and this is Y.

00:31:51.221 --> 00:31:52.163
How do you blend the two?

00:31:52.222 --> 00:31:53.523
Where do you see this space going?

00:31:53.544 --> 00:31:54.965
Can you open that up a little bit, Burt?

00:31:56.267 --> 00:31:57.828
Yeah, let's jump in here.

00:31:57.929 --> 00:31:59.510
There are two opposite ends

00:31:59.550 --> 00:32:00.330
of the spectrum, right?

00:32:00.351 --> 00:32:02.453
The art of it and then the science of it,

00:32:02.493 --> 00:32:02.653
right?

00:32:02.693 --> 00:32:03.054
They are...

00:32:04.166 --> 00:32:05.047
I think a lot of things

00:32:05.106 --> 00:32:06.587
exist on a binary scale.

00:32:06.788 --> 00:32:07.588
They're black and white,

00:32:07.669 --> 00:32:08.669
but as we all know,

00:32:08.788 --> 00:32:10.269
many things exist in the gray.

00:32:10.309 --> 00:32:12.550
There's very few things, not very few.

00:32:13.471 --> 00:32:15.652
There's a lot of things in

00:32:15.672 --> 00:32:16.673
the human performance,

00:32:16.712 --> 00:32:17.993
high performance space that

00:32:18.054 --> 00:32:19.094
exist in the gray.

00:32:19.733 --> 00:32:21.775
There's some things that are absolutes.

00:32:22.276 --> 00:32:22.435
Um,

00:32:22.756 --> 00:32:23.855
and I think you have to an appreciation

00:32:23.875 --> 00:32:25.037
of what those absolutes are,

00:32:25.696 --> 00:32:28.057
but for example, like, you know,

00:32:29.298 --> 00:32:30.278
what's like an absolute

00:32:30.298 --> 00:32:31.599
that we probably all at all agree on.

00:32:31.900 --> 00:32:33.221
Like we know VO2 max is

00:32:33.241 --> 00:32:34.884
important for aerobic endurance, right?

00:32:34.904 --> 00:32:35.566
We know like, hey,

00:32:35.586 --> 00:32:36.647
if you want to be fit and

00:32:36.667 --> 00:32:37.750
you want to have a high capacity,

00:32:37.769 --> 00:32:39.813
you better have a high VO2 max.

00:32:39.833 --> 00:32:41.255
Like that's probably an absolute, right?

00:32:41.415 --> 00:32:42.718
Now what that absolute number is,

00:32:42.738 --> 00:32:43.439
is probably dependent on

00:32:43.459 --> 00:32:44.701
the sport and probably dependent on

00:32:45.441 --> 00:32:47.082
the age of the athlete, positional demands,

00:32:47.122 --> 00:32:47.961
so on and so forth.

00:32:48.021 --> 00:32:49.301
But I think we can all agree

00:32:49.342 --> 00:32:50.321
like an absolute standard

00:32:50.342 --> 00:32:51.542
would be a high VO2 max,

00:32:51.583 --> 00:32:52.863
maybe 55 milliliters.

00:32:52.982 --> 00:32:54.923
I forget the milliliters per kilogram,

00:32:54.963 --> 00:32:56.044
probably 55 greater would

00:32:56.064 --> 00:32:56.784
be a good standard, right?

00:32:56.824 --> 00:32:57.484
That's an absolute.

00:32:57.825 --> 00:32:59.204
Going back to my exercise fizz days here.

00:33:02.726 --> 00:33:05.666
So the tech side of things,

00:33:05.946 --> 00:33:06.948
what I think the tech now,

00:33:06.968 --> 00:33:07.847
what I've learned over the years,

00:33:07.867 --> 00:33:08.327
let me just speak from

00:33:08.367 --> 00:33:08.847
personal experience.

00:33:08.887 --> 00:33:09.988
What I've learned over the years,

00:33:09.988 --> 00:33:11.828
80% of the time,

00:33:12.648 --> 00:33:14.509
what I see in technology and data

00:33:15.874 --> 00:33:16.554
When it comes to just

00:33:17.535 --> 00:33:18.715
talking about performance

00:33:18.996 --> 00:33:20.395
and physical therapy and rehab,

00:33:20.395 --> 00:33:22.116
80% of the time,

00:33:22.597 --> 00:33:24.459
the tech validates my own intuition.

00:33:25.179 --> 00:33:27.240
And I think that's where the art of it is,

00:33:27.359 --> 00:33:27.920
is, okay,

00:33:28.980 --> 00:33:30.501
we're four weeks into this injury.

00:33:30.541 --> 00:33:31.781
I've seen this injury before

00:33:31.821 --> 00:33:32.682
a dozen times.

00:33:32.843 --> 00:33:33.884
Usually at the four-week mark,

00:33:33.903 --> 00:33:35.324
this is what I've seen in the past.

00:33:35.443 --> 00:33:36.184
Okay, cool.

00:33:36.244 --> 00:33:37.464
Let's just go test to make

00:33:37.505 --> 00:33:38.405
sure this is what I'm seeing.

00:33:38.865 --> 00:33:39.707
Get on the, let's just say,

00:33:39.727 --> 00:33:40.527
get on the force plates.

00:33:40.567 --> 00:33:41.007
We test.

00:33:41.087 --> 00:33:41.587
Okay, cool.

00:33:41.627 --> 00:33:43.709
The symmetry is, you know, 15, 16%.

00:33:44.108 --> 00:33:44.930
That's what I thought would

00:33:44.970 --> 00:33:46.411
be a four weeks given this injury.

00:33:46.891 --> 00:33:47.290
Okay, cool.

00:33:47.310 --> 00:33:48.451
Let's just keep on with the program.

00:33:48.892 --> 00:33:49.752
And then every so often

00:33:49.772 --> 00:33:50.794
you're going to outline it says, Oh,

00:33:51.683 --> 00:33:52.384
I didn't see that coming.

00:33:52.684 --> 00:33:52.884
Okay,

00:33:52.904 --> 00:33:54.065
we got to adjust your training program.

00:33:54.566 --> 00:33:55.605
And so I look at it in the

00:33:55.625 --> 00:33:58.127
sense of technology gives

00:33:58.167 --> 00:33:59.689
me the objectivity to a lot

00:33:59.709 --> 00:34:00.789
of my own intuitions,

00:34:00.930 --> 00:34:02.931
but also the beauty of

00:34:02.990 --> 00:34:04.132
technology and it being a

00:34:04.172 --> 00:34:07.953
lot more easier from a visual.

00:34:07.993 --> 00:34:08.333
What's the...

00:34:09.536 --> 00:34:10.777
data visualization, excuse me,

00:34:10.918 --> 00:34:11.938
data visualization, right?

00:34:11.958 --> 00:34:12.757
A lot of companies are doing

00:34:12.797 --> 00:34:13.278
that really well.

00:34:13.298 --> 00:34:14.139
It was like back in the day

00:34:14.159 --> 00:34:15.460
when I was in soccer,

00:34:15.480 --> 00:34:16.340
I was still using pivot

00:34:16.360 --> 00:34:17.599
tables and trying to figure out like,

00:34:17.639 --> 00:34:19.800
how do I do conditional formatting?

00:34:20.382 --> 00:34:21.461
So, but nowadays,

00:34:21.481 --> 00:34:22.322
like we've got companies

00:34:22.382 --> 00:34:23.443
like Healthy Athlete,

00:34:23.463 --> 00:34:25.324
we've got companies like Kitman, you know,

00:34:25.344 --> 00:34:26.204
shout out Darcy.

00:34:26.304 --> 00:34:26.583
I mean,

00:34:27.264 --> 00:34:28.585
there's just so many companies that

00:34:28.605 --> 00:34:30.085
are doing data visualization really well.

00:34:30.106 --> 00:34:31.445
And what that does is it

00:34:31.485 --> 00:34:32.427
tells a story for the

00:34:32.527 --> 00:34:34.527
athlete and it showcases

00:34:34.547 --> 00:34:35.447
the journey that they are

00:34:35.487 --> 00:34:36.708
going on and seeing, okay, hey,

00:34:37.673 --> 00:34:38.393
Like we were talking about

00:34:38.474 --> 00:34:39.594
earlier in the show of

00:34:40.195 --> 00:34:41.576
sport being at the end of the continuum,

00:34:41.615 --> 00:34:42.356
health being at the start

00:34:42.376 --> 00:34:42.956
of the continuum.

00:34:43.596 --> 00:34:44.797
Well, same thing is, hey,

00:34:45.056 --> 00:34:46.878
I love testing an athlete

00:34:47.018 --> 00:34:47.958
so early in the rehab

00:34:47.978 --> 00:34:49.219
process just to show them

00:34:49.278 --> 00:34:50.418
how poorly they performed.

00:34:50.938 --> 00:34:52.260
Because then in four weeks time,

00:34:52.579 --> 00:34:54.000
when you have multiple data points,

00:34:54.400 --> 00:34:55.701
they can see the drastic

00:34:55.740 --> 00:34:56.661
change that they just had

00:34:56.722 --> 00:34:59.021
from day three of a grade

00:34:59.061 --> 00:35:00.242
two ankle sprain to day

00:35:00.842 --> 00:35:02.503
day 24 of that same ankle

00:35:02.523 --> 00:35:04.164
sprain and the trend line

00:35:04.664 --> 00:35:06.146
is so powerful or like hey

00:35:06.166 --> 00:35:07.086
return to percentage of

00:35:07.126 --> 00:35:08.527
baseline so to me the

00:35:08.608 --> 00:35:09.807
technology and data

00:35:10.429 --> 00:35:11.750
provides the information

00:35:11.849 --> 00:35:13.170
necessary to tell the story

00:35:13.670 --> 00:35:14.431
it also gives you

00:35:14.530 --> 00:35:15.751
credibility right you can't

00:35:15.831 --> 00:35:17.112
measure my intuition as

00:35:17.152 --> 00:35:18.132
much as I try to sell you

00:35:18.193 --> 00:35:19.114
on as much as I try to tell

00:35:19.134 --> 00:35:19.893
you about as much I'm like

00:35:19.914 --> 00:35:21.034
hey like this is what I

00:35:21.074 --> 00:35:21.735
believe in this is why I

00:35:21.755 --> 00:35:22.456
believe this is what I know

00:35:22.476 --> 00:35:23.155
this is what I've read it's

00:35:23.175 --> 00:35:23.896
like at the end of the day

00:35:23.916 --> 00:35:24.836
a lot of people just who

00:35:24.876 --> 00:35:25.898
don't understand the space

00:35:26.077 --> 00:35:27.239
need the tech and the data

00:35:27.719 --> 00:35:28.739
to understand what it is

00:35:28.778 --> 00:35:29.820
that you do so it gives you

00:35:29.900 --> 00:35:30.900
credibility to what you do

00:35:30.960 --> 00:35:35.021
as well it pulls back the

00:35:36.061 --> 00:35:37.481
the curtain on just trust

00:35:37.521 --> 00:35:38.981
me bro we've got this right

00:35:39.021 --> 00:35:40.983
it's very much like hey

00:35:41.023 --> 00:35:42.103
just trust me bro here's

00:35:42.182 --> 00:35:43.483
why right here's the trend

00:35:43.543 --> 00:35:44.563
line as you mentioned I

00:35:44.623 --> 00:35:46.903
think a highlight in there

00:35:46.983 --> 00:35:49.144
is the early early stage

00:35:49.204 --> 00:35:50.786
testing so that you can

00:35:50.826 --> 00:35:52.025
have that data point because it

00:35:52.873 --> 00:35:53.693
have to recognize that

00:35:53.974 --> 00:35:55.635
athletes coaches front

00:35:55.655 --> 00:35:56.856
office personnel outside of

00:35:57.016 --> 00:35:58.838
us are not familiar with

00:35:58.858 --> 00:35:59.659
what those numbers should

00:35:59.719 --> 00:36:01.061
be so if they don't see it

00:36:01.262 --> 00:36:02.422
early they don't have a

00:36:02.503 --> 00:36:03.244
reference point so if your

00:36:03.264 --> 00:36:04.224
first data points at week

00:36:04.304 --> 00:36:06.306
four or six it doesn't they

00:36:06.327 --> 00:36:08.068
don't have anything to to

00:36:08.168 --> 00:36:10.271
reference it back to so a

00:36:10.331 --> 00:36:12.472
lot of gold in there adam

00:36:12.552 --> 00:36:14.514
over the last 35 40 minutes I think

00:36:16.536 --> 00:36:18.059
You've learned so much in this space.

00:36:18.139 --> 00:36:20.043
You've been around this space for so long.

00:36:20.083 --> 00:36:21.806
Who's somebody that the audience,

00:36:21.827 --> 00:36:23.550
the listeners should follow

00:36:23.570 --> 00:36:24.853
to learn more in this space?

00:36:26.360 --> 00:36:28.579
I think the crew over in New York City,

00:36:28.619 --> 00:36:30.161
shout out Greg, Trevor, Doug,

00:36:30.221 --> 00:36:32.420
the OGs over there at

00:36:32.460 --> 00:36:33.501
Resilient Performance

00:36:34.081 --> 00:36:35.322
Physical Therapy in New York City,

00:36:35.342 --> 00:36:35.802
New Jersey.

00:36:35.822 --> 00:36:36.601
Those guys are doing a

00:36:36.621 --> 00:36:38.081
really good job in the private sector.

00:36:38.181 --> 00:36:38.762
And I believe they're in the

00:36:38.782 --> 00:36:39.822
middle of writing a book on

00:36:39.842 --> 00:36:40.722
return to play as well.

00:36:41.422 --> 00:36:42.202
So I think, you know,

00:36:42.222 --> 00:36:43.123
follow them on Instagram.

00:36:43.163 --> 00:36:44.764
They do a great job putting

00:36:44.804 --> 00:36:45.643
out good information.

00:36:45.684 --> 00:36:46.704
And just what I love about it,

00:36:46.724 --> 00:36:48.003
they're all coaches and therapists.

00:36:48.123 --> 00:36:49.625
So what they put out is actionable.

00:36:49.644 --> 00:36:50.264
It's practical.

00:36:50.744 --> 00:36:51.465
It's not fluff.

00:36:51.525 --> 00:36:51.905
It's not

00:36:53.293 --> 00:36:54.414
trying to do anything too sexy,

00:36:54.434 --> 00:36:54.875
too creative.

00:36:54.914 --> 00:36:55.815
It literally is just doing

00:36:55.835 --> 00:36:56.856
the basics really, really well.

00:36:56.876 --> 00:36:57.956
They're having great success with it.

00:36:57.996 --> 00:36:58.958
So please like, you know,

00:36:58.978 --> 00:36:59.657
shout out to the guys at

00:36:59.697 --> 00:37:00.858
resilient performance in New York.

00:37:01.940 --> 00:37:02.539
Love that.

00:37:02.619 --> 00:37:03.380
And then somebody,

00:37:03.400 --> 00:37:05.262
somebody inside this space

00:37:07.222 --> 00:37:08.583
that is inside of the sport

00:37:08.623 --> 00:37:09.425
world right now that you

00:37:09.465 --> 00:37:10.224
feel like people should,

00:37:10.385 --> 00:37:11.065
should keep an eye on.

00:37:12.255 --> 00:37:12.556
Hmm.

00:37:14.056 --> 00:37:15.476
From just a personal, I think,

00:37:15.577 --> 00:37:16.556
I think the work that Dave

00:37:16.597 --> 00:37:17.257
Tenney has done over the

00:37:17.297 --> 00:37:18.898
last 10 to 15 years in high

00:37:18.918 --> 00:37:21.199
performance in general, how he's helped,

00:37:21.219 --> 00:37:21.458
you know,

00:37:21.478 --> 00:37:22.798
soccer teams really integrate

00:37:22.818 --> 00:37:23.639
the high performance space.

00:37:23.659 --> 00:37:24.920
I think he does a really good job there.

00:37:24.940 --> 00:37:26.219
He's down now down at Austin.

00:37:26.940 --> 00:37:28.541
We crossed paths in MLS and

00:37:28.940 --> 00:37:29.940
NBA during our times

00:37:30.021 --> 00:37:31.702
together in those leagues, respectfully.

00:37:31.722 --> 00:37:33.402
And I'd say more like on the

00:37:33.521 --> 00:37:35.182
practical side of things, I think the

00:37:37.327 --> 00:37:40.449
The space of like integrating,

00:37:40.550 --> 00:37:41.050
getting back to the

00:37:41.110 --> 00:37:41.891
technology and the data,

00:37:41.911 --> 00:37:42.911
I think Daniel Bove's on

00:37:42.952 --> 00:37:43.913
some pretty creative stuff,

00:37:43.972 --> 00:37:44.974
creating some systems and

00:37:45.014 --> 00:37:46.275
frameworks for the population.

00:37:46.295 --> 00:37:46.454
You know,

00:37:46.474 --> 00:37:47.496
he's down in New Orleans right now,

00:37:47.516 --> 00:37:48.197
director of performance.

00:37:48.217 --> 00:37:49.197
So I think Bove is doing a

00:37:49.237 --> 00:37:51.420
good job with creating

00:37:52.240 --> 00:37:53.481
frameworks around load

00:37:53.521 --> 00:37:53.961
management and

00:37:53.981 --> 00:37:54.802
periodization and

00:37:54.862 --> 00:37:56.423
programming and how to

00:37:56.503 --> 00:37:57.344
manage team sports.

00:37:57.364 --> 00:37:58.126
So he's another person I

00:37:58.146 --> 00:37:59.327
would say presently that's

00:37:59.746 --> 00:38:01.389
relative to the sport of the NBA.

00:38:01.409 --> 00:38:02.530
He's a guy I'd follow.

00:38:03.561 --> 00:38:04.644
love that and then who's

00:38:04.684 --> 00:38:05.786
been your biggest influence

00:38:05.827 --> 00:38:07.030
in this you know whether

00:38:07.090 --> 00:38:08.432
inside the space family

00:38:08.572 --> 00:38:10.797
author musician who's been

00:38:10.818 --> 00:38:11.980
your biggest influence

00:38:13.105 --> 00:38:13.244
Oh,

00:38:13.525 --> 00:38:16.288
I'd say in the media professional space,

00:38:16.327 --> 00:38:18.289
it'd be Bill Hartman out of Indie,

00:38:18.510 --> 00:38:19.190
out of IFAST.

00:38:19.230 --> 00:38:20.630
He's just been a huge mentor of mine.

00:38:21.612 --> 00:38:22.492
Answered a lot of questions

00:38:22.532 --> 00:38:23.554
for me that I had or gave

00:38:23.574 --> 00:38:24.414
me the space to ask

00:38:24.454 --> 00:38:25.315
questions early on in my

00:38:25.355 --> 00:38:27.217
career when maybe perhaps

00:38:27.597 --> 00:38:29.338
that space wasn't created from others.

00:38:29.759 --> 00:38:30.739
So I think he really has

00:38:30.778 --> 00:38:32.920
just helped me think deeper

00:38:33.402 --> 00:38:35.862
and really connect ideas

00:38:36.603 --> 00:38:38.184
that understanding that

00:38:38.204 --> 00:38:39.005
this thing is way bigger

00:38:39.025 --> 00:38:40.146
than any of us can actually imagine.

00:38:41.342 --> 00:38:42.483
I love that.

00:38:42.503 --> 00:38:44.545
I love you being able to

00:38:44.606 --> 00:38:45.547
shout out some people who

00:38:45.567 --> 00:38:46.467
have helped you along the

00:38:46.507 --> 00:38:48.831
way and going back through

00:38:48.871 --> 00:38:50.711
resilience performance through MLS,

00:38:50.813 --> 00:38:51.934
NBA up until now.

00:38:52.434 --> 00:38:53.335
It's always good to be able

00:38:53.355 --> 00:38:54.036
to shout out the people

00:38:54.056 --> 00:38:55.556
that have gotten us to where we are.

00:38:55.597 --> 00:38:57.018
Now, for the listeners,

00:38:57.059 --> 00:38:58.300
how do we find out more about you?

00:38:58.400 --> 00:38:59.961
Shout out your own podcast here.

00:39:01.463 --> 00:39:04.206
Where can they follow Adam going forward?

00:39:04.913 --> 00:39:05.612
Sure thing, man.

00:39:05.813 --> 00:39:06.032
So yeah,

00:39:06.213 --> 00:39:07.373
I run my own podcast called

00:39:07.434 --> 00:39:08.233
Finding Small Wins,

00:39:08.293 --> 00:39:09.614
where we pull back the

00:39:09.655 --> 00:39:11.655
curtain on sports and try

00:39:11.675 --> 00:39:12.556
and shed some light onto

00:39:12.596 --> 00:39:14.436
how others can learn from

00:39:14.657 --> 00:39:15.436
the environments of pro

00:39:15.456 --> 00:39:16.356
sports so that they can

00:39:16.396 --> 00:39:17.677
upgrade their own health and performance.

00:39:17.717 --> 00:39:18.237
So by all means,

00:39:18.277 --> 00:39:19.438
please check out that podcast.

00:39:20.338 --> 00:39:21.960
I have a website that has a

00:39:22.039 --> 00:39:23.101
bunch of free resources on

00:39:23.181 --> 00:39:24.460
it relative to Return to Play,

00:39:24.521 --> 00:39:25.222
high performance.

00:39:25.802 --> 00:39:27.463
It also houses the podcast as well.

00:39:27.503 --> 00:39:28.523
So I'd say the website,

00:39:28.664 --> 00:39:30.605
adamliacono.com is my name.

00:39:31.025 --> 00:39:31.806
So hopefully more people

00:39:31.826 --> 00:39:33.005
learn how to pronounce it correctly.

00:39:33.025 --> 00:39:34.927
I just figured to just put

00:39:34.947 --> 00:39:36.068
it in the website name itself.

00:39:36.728 --> 00:39:39.369
And yeah, Finding Small Wins Podcast.

00:39:39.389 --> 00:39:40.971
And that's my name across all socials,

00:39:41.030 --> 00:39:42.672
adam.liacono across all the socials.

00:39:44.070 --> 00:39:44.530
Awesome, man.

00:39:44.590 --> 00:39:44.791
Well,

00:39:44.911 --> 00:39:46.492
I appreciate you taking some time

00:39:46.532 --> 00:39:48.554
today and being on the show

00:39:48.614 --> 00:39:49.594
and always good to chat.

00:39:49.635 --> 00:39:50.536
I'm sure it won't be long

00:39:50.556 --> 00:39:51.376
before we talk again.

00:39:51.976 --> 00:39:52.677
Thousand percent, man.

00:39:52.697 --> 00:39:52.976
It's fun.

00:39:53.157 --> 00:39:53.898
Thank you for having me on.

00:39:53.938 --> 00:39:54.898
I'm great to catch up with you.

00:39:55.918 --> 00:39:56.280
Absolutely.

00:39:56.300 --> 00:39:56.780
We'll talk soon.