Success of Suns' training staff a tantalizing carrot for veterans
In any normal season, an NBA team with no injuries after 14 games wouldn't be much of a story. But this is no ordinary season, not with teams often squeezing in five games in six nights thanks to the lockout.
Already, All-Stars Dwyane Wade, Dirk Nowitzki, Chris Paul and Derrick Rose have missed time with an assortment of maladies. But on Wednesday, the Phoenix Suns rolled into New York without a player injured or inactive. That's no small feat for the league's fifth-oldest team with a starting lineup that includes two players over the age of 37. It's also become commonplace for a training staff that has earned praise across sports for its unique methods and results. With a track record that includes helping a hobbled Shaquille O'Neal regain his All-Star form at age 36, reviving Grant Hill's career when he was encouraged to end it after multiple ankle surgeries, and helping Steve Nash maintain 10.0 assists per game at age 37, the Suns' training staff also has become a subtle recruiting tool for veteran free agents.
"The staff assessed me and said there were things I'd been dealing with my whole career that were very correctable, and if I were to sign with Phoenix that I would feel better than I have in the past" said 32-year-old guard Michael Redd, who followed that advice and signed a one-year deal with the Suns in December after missing 185 games over the previous three seasons. "That was one of the things that brought me to Phoenix. ... I saw what they did with Grant and how they revitalized his career and he's still flying at age 39. And you've got Steve Nash, who's playing at a high level. That was encouraging for me."
Nash has averaged 77 games a season in his seven years in Phoenix while leading the league in assists five times. This season has been no different, with Nash again atop the assists leaderboard despite playing the fewest minutes (31.4 per game) of his career since 1999-2000.
Hill's transformation from health casualty to Iron Man has been even more impressive.
After missing 292 games in six seasons with the Magic, Orlando ownership was more willing to offer him a buyout than spend more time on his recovery from five foot and ankle surgeries. Under the Suns' care, Hill has missed 15 games combined over his first four seasons and drew interest from the Bulls and Knicks in free agency last summer. Hill chose to remain in Phoenix and signed a $6.5 million, one-year deal.
"I had the intention of trying to squeeze out two years when I left Orlando and then looking to move on," Hill said in a recent phone interview. "Now I'm going on five years and [the Suns' training staff] is telling me I can go another couple of years."
While Suns head trainer Aaron Nelson is quick to credit the commitment both Nash and Hill have put in to their health, the Suns' success is built largely on a philosophical approach that differs from many training staffs in the NBA. "Most teams treat athletes from a regional perspective," Hill said. "If your knee hurts, they treat the knee. [The Suns'] approach is to try to find the root of the problem, what's causing the knee to hurt. It might be that the opposite ankle's flexibility is not good, or your hamstrings are tight, or the SI (Sacroiliac) joint in your lower back is off. They spend a lot of time digging into your body and it involves a lot of manual therapy. It's part art, part science."
The Suns' strategy emerged in 2000, when, after seven years as an assistant, Nelson became the team's head trainer and began working with Michael Clark, a recognized physical therapist at the National Academy of Sports Medicine.
"I was looking for some way to change not only how we treat and rehab injuries but how we prevent injuries," said Nelson. We've always looked at mechanisms of injury regardless of philosophy. But a lot of injuries are chronic in nature.
"Say a guy rolls his ankle: Outside of treating the ankle for swelling and maybe some ligament or tendon injury, we'll also look at what he may be predisposed to going forward. Could it be something that turns into plantar fasciitis, anterior knee pain, low back pain? And maybe it is something from that specific area of the foot and ankle, but a lot of times we'll see changes in the hips, glutes strength or pelvic rotation. So we'll constantly reassess and make sure everything is moving the way it is supposed to move."
What Nelson and his staff don't learn through simple observation they examine with a plastic, compass-like device called a goniometer that measures angles of flexibility of various joints. "Then we'll put them in a position to test muscle strength and that is just using us as resistance," Nelson said. "There are really no computers; it's the goniometer and us."
The process takes three to four minutes for each player, after which they are treated with 20-30 minutes of manual therapy, such as stretching and massage. "That can be fatiguing and grueling, and equally so for the player because it's not a pain-free situation when they're on the [massage] table," Nelson said. "A lot of manual therapy doesn't feel the best when you're trying to get someone to move in a certain way."
Combined with weight-room exercises designed to correct muscle weaknesses and imbalances, the Suns' reliance on manual treatments veers from more standard treatment tools such as ultrasound, electrical stimulation and ice, known as modalities.
The results haven't been standard, either. O'Neal arrived in Phoenix in 2008 seemingly on a fast track to retirement. Thanks to a series of nagging injuries, Shaq had played a mere 40 games in 2007-08, his last full season with Miami, before being dealt to Phoenix. After extending what Nelson described as a "poor range of motion" and increasing "poor strength in certain muscles," O'Neal played the most games he had in eight seasons (75) while winning a share of the All-Star MVP award in 2009. In appreciation, Shaq paid homage to the staff by bestowing them with a nickname, the YUMS, the Young Unorthodox Medical Staff.
Hill's return to productivity was even more unlikely. "He couldn't stabilize, couldn't balance and do a lot of the things you need to do to play basketball or even be a stay-at-home mom," Nelson recalled. "We addressed a significant loss of range of motion and strength in his foot, ankle and lower leg. But a lot of his issues were coming out of his hips and back."
After a career filled with medical stops and starts, Hill said one of the more difficult aspects of his recovery was learning to trust Nelson's techniques. "At first I was thinking, 'how do these exercises translate from a controlled environment in the weight room to the court?'" Hill said. "But over time you learn to fire certain muscles, you learn to control movement, and as you carry that onto the court, it maintains."
Suns coach Alvin Gentry also has learned to trust the trainers' opinions in governing not only the minutes of individuals, but also the team as a group. "Aaron will tell me, 'We need to play Steve 20 minutes tonight, not 28,' or, 'I know we want to practice but let's not do that; they're better served with the day off.'" Gentry said. "And I listen because they've got a great pulse on our players."
With Redd the latest addition to the Suns' fountain of youth, it's clear Gentry isn't the only one listening.