Finding a First Rate Medical Staff™

In the interview with Henry Abbott, the Blogfather has some interesting stuff to say about the controversy surrounding the Blazers' medical staff, and the rash of injuries to key players:

Should Portland's training staff take some blame?

"It's too hard to know. I'll tell you this, man. If I owned an NBA ... How much is it worth? Could you possibly overpay the Suns training staff. They're probably worth -- if they can get Greg Oden playing, give him an extra year of productivity -- they're worth 30 million dollars or something like that. I don't know why you wouldn't put so much money into that. Or Arnie Kander in Detroit. These guys who just know how to get players playing and happy and healthy. They are worth their weight in absolute gold. And I can't understand why they're not just top of the list in coveted NBA personnel."

Like Henry, I don't know.  Phoenix and Detroit's medical staffs are considered the best in the league; Portland's is not. 

Which brings us to the question:  How DOES Portland get a top-notch medical staff, if we assume we don't have one already?

I should note, at the outset, that this post is not a call to get rid of Jay Jensen or any other members of Portland's medical staff (trainers, team doctors, therapists, whoever else).  Nor is it a call to defend them.  I know next to nothing about sports medicine, and have no basis on which to evaluate the medical staff beyond the fans' complaint of "players get hurt a lot", which might be due to factors beyond the trainers' control.  I assume that all current members of the staff are professionals in their field, acting in good faith and in accordance with their training (if they are not, that's a separate issue, and one more easily resolved).   However, if we assume that a) we want a top-notch medical team, and b) we don't have one at present, then obviously SOMETHING must change; whether that means replacing the current personnel, or retraining them, or supervising them, I don't know.

Abbott notes that Paul Allen has lots of money, and suggests that he simply makes the Phoenix and/or Detroit staffs offers they cannot refuse.  Unlike players, there is no salary cap for medical and training personnel.  Paul was one of the first owners (along with the owner of the Pistons) to invest in a private team plane--up until the late 1980s, NBA teams flew commercial--and now it's standard equipment for NBA teams to fly charters. 

But assuming that the Suns' or Pistons' medical staffs are unwilling or unable to relocate--what next?  What do these teams do differently that other teams don't do?  Finding that out ought to be a key item on Rich Cho's agenda.  

A few thoughts in that regard:

  • There is a significant dividing line, it seems, between the world of doctors and the world of trainers.  The medical profession is heavily professionalized, and generally tries to be scientific as possible.  (There's still a lot of art in medicine, but much research in medicine is directed towards reducing this).  The discipline of athletic training, OTOH, seems to be on a less firm scientific footing--and it seems to be here wherein the problem lies.  (The team physicians seem to do a fine job of repairing injuries in the operating room, however they are needed far too often).  Things are better than they were--in decades past, it wasn't uncommon to withhold fluids from players during practice or games, on the theory that this will "toughen them up" or similar nonsense.  However, there is still much "art" in training, and many professional trainers advocate training techniques which lack a firm scientific basis.  I'm not sure I entirely blame them given the state of the science.
  • The world of sports, including pro sports, still involves a large degree of machismo concerning injuries--players are frequently urged to ignore injuries and "man up and play".  Fans are frequently the worst offenders--after Greg Oden chipped his patella back in 2009, and took longer than projected to come back, lots of doubters came out of the woodwork and questioned his commitment to rehab; this only scant months after Martell Webster was lost for the season after coming back too soon from a stress fracture.  But sometimes, the pressure to play through pain (which may or may not be a good idea) comes from coaches and management (I'm speaking in general here, not of the Blazers in particular)--coaches and GMs want to win, and don't like seeing high-priced talent sitting on the bench in street clothes.  The NFL is probably one of the worst offenders (non-star players are frequently treated as disposable by the league)--The Onion did a hilarious spoof NFL concussion poster, which highlights the cultural problem
  • Given that:  Should there be one person near the top of the organization (a full-time employee, reporting to Rich Cho or higher--this person should not report to the coach) which oversees the Blazers entire medical team?  This person would supervise the trainers and strength/conditioning coaches, as well as relationships with any physicians hired/contracted by the team, and have the ability to keep players out of games.  Perhaps there is somebody already in this role--how extensive Dr. Don Roberts (the team physician) is involved in day-to-day activities of the team is unclear.  (He has his own medical practice outside of the Blazers, and appears to be a consultant to rather than an employee of the team). 


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