Chicago Bears linebacker Lamarr Houston tore his ACL in September of 2016 in a game against the Philadelphia Eagles. It wasn’t Houston’s first injury. He had torn his ACL before -- twice, in the last three years -- but his approach to recovery was one that’s fairly new, and increasingly practiced in professional sports. He began active recovery a mere 30 hours after surgery and was guided by a team of sports medicine professionals assembled ad hoc and tailored specifically for his needs. In addition to his usual dietary regimen (no dairy, little to no simple carbs, all-water fluid intake), he began a rigorous physical therapy and training program that was designed to optimize every aspect of his physical and mental recovery, aided by a hand-picked team.
This is not the standard model for recovery, which still dominates the industry ― a prescription of RICE (rest, ice, compression, elevation), cortisone shots, anti-inflammatories, and sometimes a low tech solution: a glass of wine and a hot tub. And recovery programs are typically implemented top-down by medical teams whose prescriptions are one-size-fits-all and often dominated by one person, usually the team surgeon who operated to repair the injury.
The new model is active recovery, where healing involves continuing to train while recovering, and this process is best managed collaboratively among a team of strength and conditioning coaches, movement specialists, soft tissue specialists and other professionals who create an integrated program for the athlete. Athletes like Houston who understand this new athlete-centric model are beginning to form their own individualized medical and strength teams who can work together integratively and ensure that no one team member unintentionally undermines or diminishes the work of another.
And the effect is pronounced and clear: injury rates are lower across the board, and players spend less time off the field. And as a result, it reduces cost. If sport science can be moneyballed, this is the model for doing it.
A new model for injury ownership
One of the biggest advantages of the new model is that it changes the way injury ownership is managed and owned. Historically, strength and medical staff play specific pre-defined roles: the strength staff breaks the athlete down, and the medical staff puts the athlete back together. The medical staff’s inclination to keep athletes resting during recovery sometimes results in increased injury because the athletes aren’t physically prepared to resume play, and any work the strength staff is doing to ensure that the athletes were maintaining constant work loads can be undermined by the directives of the medical team. Athletes returning to excessive and rapid training loads after a period of injury are more likely to face new injuries in this scenario. Each member of the team works in a silo, with little collaboration. As a result, overloading and under-loading can happen anywhere from the rehab room to the gym to the field.
The new model stops this from happening. It is highly collaborative and allows for constant communication, which is critical to reduce training load errors and maximize recovery. The coaching staff, the conditioning team, sport scientists, therapists, and the athlete are perpetually exchanging information, evaluating the athlete’s recovery and training program, and adjusting accordingly. It is a dynamic process that adapts to the athlete’s changing needs.
It also adapts to the individual athlete and this is crucial because each athlete’s physiology is different. Identical external loads like pitch count could elicit very different internal loads (i.e., perceived exertion and heart rate) between athletes, and the disparities must be taken into account. One size never fits all.
Ian MacIntyre, a sports specialist chiropractor who works extensively as a consultant for various NHL members and teams (as well as athletes from the CFL, NFL, MLS, PGA, UEFA Champions League and UFC) believes this customized and collaborative model is the future. “In ten years, you’ll see this model in all sports,” he says. “You won’t just have the team surgeon in charge. It requires the whole team. In sports, you can’t separate medicine from strength and conditioning. They are one and the same.”
Talent isn’t enough
The focus of the new approach is quick, active recovery that pays special attention to proper movement. “Athletes and training staff are constantly looking for ways to help athletes recover safer and faster so they can keep the workload consistent,” says MacIntyre, who is also an expert on injury rehabilitation. “This means soft tissue therapy, hydration, nutrition, supplements, sleep and optimizing body mechanics with proper training are at the forefront of sports medicine.”
The new model also ensures that athletes are able to train harder and smarter. This means optimizing not just the athlete’s assembled team of professionals, but by having the athlete practice correct movements that will build automatic neural pathways and enhance muscle memory. This means that overall time spent practicing is less important than practicing with a specific goal in mind. It means moving away from lifting as the primary means of strength training. And it means utilizing movement experts who can customize the athlete’s training program with an eye toward deep, directed practice that enhances those neural pathways by myelination -- the building up of myelin -- which allows for faster circuit patterns and more efficient and effective play. This is also best done as a team effort because the process is holistic and each step is integrated.
This contradicts conventional wisdom that performance is primarily dependent on natural athletic prowess—and that practice is best evaluated in terms of volume. Talent isn’t enough, and neither is 10,000 hours of practice.
Lamarr Houston knows this, and knows that it’s not just about being able to get back on the field after an injury: he has to meet and exceed previous performances. And there are other athletes like Houston who are looking to thrive and are doing this on their own -- hiring strength coaches, soft tissue specialists who don’t work for the team. They’re building their own teams to achieve their goals -- moneyballing themselves -- which is increasingly crucial in a sports economy that is producing longer seasons with more games.
The happy athlete
And there’s one last key advantage to the new athlete-centered approach. The old “military” model of training forces athletes to train harder when they underperform, sometimes in ways that result in overtraining, or inappropriate training for the individual athlete. Training feels like punishment. Younger athletes in particular dislike this model and find it demoralizing.
Individualized training with integrated teams ensure that this doesn’t happen, and that training is used to optimize future performance instead of penalizing past performance. The benefit is partly psychological but important. Athlete performance levels go up; they are more energetic; they are thinking clearly; they are well-rested; and they are focused. So not surprisingly, they are happier. And that translates to better performance on the field, and off.