It’s not a stretch to say the Phoenix Suns training and medical staff are considered to be a cabal of sorcerers. From keeping an aging (and expanding) Shaquille O’Neal healthy, to returning Grant Hill to productivity after years and years of chronic injuries to keeping Steve Nash on the court for heavy minutes even as Nash’s body (especially his back) started to balk, the Suns staff has performed apparent miracles.
Seemingly whenever a talented player’s career is derailed by health concerns, “if only he played for the Suns” has become a common lament. What if New Orleans had let Eric Gordon sign there? What could they do with poor Greg Oden? If Dwyane Wade was going to leave the Heat, he should have gone to Phoenix! And so on.
How the Suns training team is able to achieve these results is largely shrouded in mystery. Perhaps realizing Head Trainer Aaron Nelson and company’s methods are a sizable competitive advantage over the rest of the league, Phoenix tightly controls media access.
However, there is some information out there about Phoenix’s methods. Though slightly dated, this Michael Schwartz Valley of the Suns piece discusses Nelson’s overall training philosophy:
But to head athletic trainer Aaron Nelson, the Suns’ methods only seemed unorthodox to Shaq because he wasn’t used to them.
“To him it’s unorthodox, to us it’s regular science,” Nelson said. “It’s regular kinesiology, physiology, functional anatomy.”
In a nutshell, the Suns aim to ensure that a weakness in one area does not compromise other parts of the body. For example, if a player injures his right ankle he will start compensating by putting more stress on his healthy side, so the training staff treats the entire athlete and not just the injured part to ensure “there is no movement dysfunction,” as Nelson put it.
More specifically, the Suns chart an abundance of information on each player. This process starts with an overall assessment in the preseason that’s used as a baseline, and then rotation players are continually reassessed at least four times a week, if not daily.
(really, even if it is a few years old, read the whole thing)
But how does this holistic approach to injury treatment and prevention actually work? Since the Suns themselves aren’t talking, I decided to ask an industry professional.
Ren Caldwell, NSCA CSCS, FMS, is a Seattle-based strength and conditioning coach focused on improving movement patterns for better performance. Her primary work with high-level athletes is in the sport of ultimate. In ultimate much like the NBA, keeping a team’s best players healthy and on the field of play can be as large a component to success as overall talent and strategy. As Phoenix’s then head coach Alvin Gentry told Schwartz, “our guys play.” As simple as that is, it’s a huge component of success.
Caldwell’s approach is similar to the one described by Nelson and staff. Beginning with taking the baseline of each player through a test known as Functional Movement Screening, Caldwell can identify dysfunctions in the kinetic movement chain which can indicate either existing injury or identify potential susceptibility to injury. Additionally, these inefficiencies also can cause lessened athletic performance through what she termed “energy bleed” or effort put into non-functional movement. Her description of the process is that without a this baseline assessment, trying to diagnose an injury is “like trying to read one page of a book to try to figure out why someone’s knee is hurting. I need to have some history, and see how they move when they aren’t on the court or field, then we can talk about where the specific injury is coming from.”
I asked Caldwell to watch some video taken of the Suns Las Vegas Summer League team warming up before a game. I asked for her thoughts on the exercises involved and how they related to the mission of injury prevention through range of motion and stability. She was much impressed: “This is a great movement progression. The exercises innervate the glutes and core, making them the prime drivers.” she said.
Making the glutes take more of the athletic load is a big part of Caldwell’s methodology. “A lot of people strain their hamstrings or back and think ‘oh I need stronger hamstrings.’ But actually their hamstrings are strained because they are overused because they aren’t using their glutes enough. So you get them to use their glutes more, voila. Their hamstrings are no longer strained all the time. We didn’t have to go back and strengthen that muscle, it’s all about taking the pressure off it and let the thing (the glute) that is supposed to be doing the work do the work.” Similarly, low back problems (long the bane of taller basketball players from Steve Nash to Joel Embiid) are often attributable to a lack of hip mobility which can cause the lower spine to round during intense activity.
Tackling the sequence one movement at a time, she continued. “Exercises like the single-leg squat with side reach:
and the leg reach:
encourage the hips to be mobile and the pelvis stable, which optimizes glute function.”
“The lateral lunges require more strength and core stability.”
“The light diagonal hops are the first explosive movement, but very relaxed. The full-body reactive tension and true explosiveness will come later when it’s needed – right now the focus is on the body moving as a unit and listening to the breath.”
“Lateral bounds are such an important warm-up for basketball, but a lot of teams and individuals jump into them without getting the great glute support and pelvic stability that’s elicited by the prior exercises. The glutes are our powerhouse, and also one of our biggest knee stabilizers, so it’s very important to get the best activation before you move into game-specific drills.”
“The easy jogs across the court at the end of this section moving into slightly faster runs, turn on a different kind of spatial awareness and bring the pace of the movement up to more game-like levels. This is a great transition to more skill-specific and game-like drills.”
Based on the warmup video and other information reported about the Suns’ methods, it appears the Phoenix training team recognizes the importance of the glutes. In fact, as reported in Sports Illustrated in 2008, much of O’Neal’s resurgence in Phoenix was attributable to strengthening those muscles:
“His butt muscles, that was the biggest thing,” Suns athletic trainer Aaron Nelson said. “He knew that. We do manual muscle testing to show if a muscle is weak or strong, and it was pretty much nothing there.”
Shaq’s base, Nelson said, affects “everything that he does, from being able to run straight ahead, to go side-to-side, to pivoting, stuff that he does normally. Rebounding and coming down, he’s got to be able to stabilize. That muscle is a very important muscle, and if that’s weak then you’ve got a lot of other compensations.”
Shaq credits the Suns’ training staff with extending his career(.)
“I had pulled a hip muscle, and when you pull one muscle, the other muscles start to overwork. So with me pulling this muscle, all these muscles shut down, and then my ass muscles were starting to work. And that’s where all the pain was coming from.”
Speaking of the warmups, Caldwell added that while this is a quality “bridge” activity between an initial warm-up and traditional basketball activities like lay-up lines, there was very likely to be a great deal of individualized mobility work assigned to each player to address specific areas of concern. A video produced by the Suns themselves a few years ago confirms this hypothesis. Mike Elliott, the team’s Strength and Conditioning coach (seen demonstrating the exercises in the above video as well) described it thus: “Before the game, all of our players have individualized corrective exercises that are tailored to their individual needs and individual bodies, things that are tight or weak. So that’s all addressed before the game. They all have four or six or maybe even eight exercises they go through before the game, twice. Everyone of our players does that before every game.”
While Caldwell can make some educated guesses as to what the rest of the training program entails, this warm-up is a small slice of a much larger plan. That said, “this is demonstrative of a bigger picture. There is some focus on getting the right joints mobile and the right joints stable and having the body be able to work together as a whole. I would say this is probably something that is happening in the weight room and on the players’ own time as well.”
Additionally the players themselves might benefit from more physical awareness. “The more you know about how your body is supposed to move, the easier it is to catch things before they become major issues.” Caldwell said. “There’s always going to be things that happen: impacts or sprained ankles that happen because of contact. But there are so many things you can fix and prevent by working on movement. If you teach someone how to plant and turn and be very glute driven, there’s less likelihood of rolling an ankle or even an ACL-type injury. I like to bring it back to performance. You don’t play sports to not get injured, you play sports to be awesome and perform at your highest. So it’s really handy that the same stuff that’s good for injury prevention is good for performance. Fixing those movement patterns and fixing those injury leaks is going to make you a better player.”
So, while we still don’t know much about the specifics about the Suns’ medical magicians, we can start to see some general patterns and philosophies emerge. Until the league as a whole catches up, this is likely to remain a competitive advantage for Phoenix, as the organization itself recognized: the training staff was signed to new, multi-year contracts, prior to the 2013/14 season.