The Trainer's Take

Since 1984, one constant remains in the Los Angeles Lakers locker room from the days of Magic Johnson and Kareem Abdul-Jabbar: head athletic trainer Gary Vitti.

Having just completed his 28th NBA season – not to mention hundreds of playoff games – Vitti joined us to lend some perspective on the second lockout-shortened season he's overseen, offering details about how he, his staff and some good fortune got the Lakers through the compressed season in relatively excellent health:

MT: We spoke at length prior to the start of the (abbreviated) training camp, and you shared how every team's staff had to be concerned about certain types of injuries occurring. Kobe Bryant, Steve Blake and Matt Barnes all suffered various impact injuries, but there were no "major" injuries despite the compressed schedule. How do you reflect on 2011-12?
Vitti: I think we came through the season pretty well. The exceptions were indeed a few traumatic injuries such as Kobe's shin injury. We had to shut him down, even though he may not have needed to miss all seven games because it was important to do that at the time. That ended up working out as he was healthy in the playoffs. Other than that, the only macro traumatic injuries were Steve (rib cartilage, 13 games missed) and Matt (ankle sprain, one game missed, lingered in playoffs), plus Kobe getting his nose broken at the All-Star game and his preseason wrist injury.

MT: And your concern was more about wear-and-tear injuries, as opposed to the traumatic ones that can happen at any time to anybody?

Vitti: Correct. The micro traumatic injuries were our big concern with the truncated season, because you just don't get the same recovery time. The body can go through inflammatory processes due to all the attrition that results, like tendinitis and arthritis. I have to compliment Mike Brown for helping prevent injuries, because it was a real fine line with a new coaching staff needing and wanting to practice, but not being able to because the players needed more recovery time. Mike was so great to work with; he understood the big picture. Even though there were times he knew the team needed to be on the court and practicing, he chose to give them time off when we discussed it so they wouldn't break down. That's a tough decision on his part, but he did it in a professional way … and he got returns on his investment.

MT: After spending 12 years with Phil Jackson, what was it like having a new head coach in the mix with Mike Brown? You mentioned that he really seemed to embrace what you had to say and was very easy to work with?

Vitti: Yes, Mike and I hit it off right off the bat. I can't imagine anyone that wouldn't get along with Mike, so I don't think it was something special I did. He's a special guy, an open guy, and if you sound like you know what you're talking about, he will listen to you. You'd have to ask Mike, but I think from his standpoint, the success of the franchise as a whole gave those of us that have been here a level of credibility. I think that helped. But he's a great guy, a visionary in many ways, and he and I talked a lot about numerous things. He has an open door policy, which is important because he works a lot. He is often bunkered in with his assistant coaches in what I refer to as summit meetings, like for world peace or something – not Metta – but when I'd come to see him he stopped everything, and was very attentive. He never gave me the feeling I was bugging him. That trust level really worked out, and while as a team we didn't get where we wanted to go, it wasn't because players were on the sideline injured.

MT: While very few games were missed due to injury -- Andrew Bynum most notably missed only one and Pau Gasol zero -- that doesn't mean everyone was fully "healthy," right?

Vitti: What the public didn't see was that a lot of our guys were in the training room with (team physical therapist) Dr. Judy Seto and our weight room with (strength and conditioning coach) Tim DiFrancesco, constantly working on alignment issues. This is because if you're not aligned properly, the loads go to certain places that they should not, and you become symptomatic. When the load is being applied to wrong place, those areas will go through a metabolic change, become inflamed as you fatigue and eventually break down. So we're constantly going through that process with our players, trying to keep them aligned, and my staff did a great job of that.

MT: Along those lines, isn't it accurate to say that not a single Laker is heading into the offseason with an injury?

Vitti: As a matter of fact, we have exit physicals at the end of the season, when certain guys get scanned to make sure we're not leaving any open ends so that when we go to training camp we don't have any lagging injuries. This year, we didn't have one. Not a single injury. So we finished the season as healthy as we started it.

MT: Always a great thing to hear for a trainer…

Vitti: The plan was to only be on the floor when we needed to be. We stuck to it, we got the players as much rest as we could, we executed preventative measures and we got lucky. I'm not going to deny that, because some teams were unlucky.

MT: OK – how much is getting unlucky, and how much is muscles having a greater chance to be injured because they are fatigued?

Vitti: You can make an argument in our business that if you're fatigued, the muscles that are supposed to be stabilizing forces aren't able to act as such. To go back a step, you have muscles that are primary movers, others that are secondary movers and then stabilizing muscle groups. As you fatigue, your dynamic stabilizers – which are muscles – don't fire to stabilize a particular joint, which puts you at risk. I don't know that you can scientifically make that argument; I don't know how you prove that, but it is inferred. If you have X, then Y happens. You can infer that the injuries are related to the minutes, but it could also be the law of averages: the more time you spend on the court, the more likely an injury is to occur. There are a lot of variables in there.

MT: Let's say you've been practicing heavy all week and had three games, then in the fourth quarter of the fourth game in six nights, your calf and thigh are fatigued and thus less likely to help cushion your knee on a cut. Does that make sense?

Vitti: Let me give you an example that's happened to you or anyone that's played sports. Have you ever started to sprain your ankle and for some reason it doesn't go all the way over?

MT: Of course.

Vitti: There's a reason why. There are little microscopic receptors in your joints and tendons that sense length. When you start to roll that ankle, these things sense that you're going into a range of motion that's not normal and send a signal to that muscle to contract, fire and bring your foot back into a neutral position. So, with the situation you described, if you're fatigued and things don't fire fast enough, the body part is going to go the rest of the way. Now, you can be fresh as a daisy and come down on someone's foot, and you have no shot at (not rolling the ankle). Those recpetors never had a chance to do what they were supposed to do.

MT: You were able to bring Dr. Judy Seto on board full time this season. She's been working with you and the Lakers for years -- particularly Kobe Bryant — and traveling with the team in the playoffs, but never full time. What kind of difference did it make having a renowned physical therapist that has the full trust of the players with you on staff full time?

Vitti: It was great to have Judy here every day, with her office right next to mine, us in constant communication about the team. There's nobody that knows Kobe's body better than Judy, so that's a huge help. And over the years, she's gotten to know Pau (Gasol) and Andrew (Bynum) very well also. Those three guys were in the training room all the time. Generally, we did a lot of alignment things with the players which allowed us to stay in a preventative mode all the time, looking at the entire kinetic chain. As an example, if a player comes in with a sore groin, we wouldn't necessarily just look at that body part, but instead the entire body. Having Judy every day was much different from having her in spots, because she could monitor things better seeing guys every single day as opposed to once a week, and trying to play catch up. We were trying to stay one step ahead at all times.

MT: You added another new member to your training staff this season in strength and conditioning coach Tim DiFrancesco, whom like Dr. Seto you mentioned earlier. The players really seemed to like what he brought to the table this year…

Vitti: Absolutely. Tim was a sponge in his first year. He spent a few years in the D-League, so it wasn't his first exposure to basketball. His being an athletic trainer and physical therapist in addition to being the strength and conditioning coach meant he had a lot of credentials to offer. It's nice to have another physical therapist in your weight room, because it brings a different angle then what we'd normally do. That room is for strength and conditioning, but now that we have a PT in there, it's sort of strength, conditioning, rehab and prevention. It just adds more dimensions.

MT: You've mentioned to me before that Tim did a lot with and for World Peace? I won't even make the "no pun intended" joke.

Vitti: Tim did a great job getting Metta in shape. He came into training camp not looking so good, out of shape and with alignment issues, but he finished the season looking great. Once again looking at the entire kinetic chain: his back injury may not necessarily have been related to other issues he had, but the whole chain was out of alignment. What we do here is figure out that malalignment and adjust it but if that player lacks the strength and endurance to keep their alignment, they will keep going back to their default position, which creates compensation that leads to dysfuntion. So, No. 1, you have to align them, and No. 2, you have to work at the strength and endurance to keep them aligned. Where that becomes very tricky is in volume of work, because they have to do exercises to keep alignment. How much can they do while at the same time playing basketball and staying in condition? You want them to work out to keep their alignment, but you don't want to fatigue them so much that it affects them on the floor. It's a very difficult thing to balance and identify, an inexact science that is different for everybody. So you evaluate and re-evaluate every single day.

MT: So you as head athletic trainer are essentially doing triage as a doctor would do at an emergency room.

Vitti: Right. For example, if a player comes in with a certain situation, I'll want them to work only with Judy. In another circumstance, I'll consult with Judy and then have the player work with Tim or (assistant trainer) Marco Nunez or (massage therapist) Marko Yrjovuori, both of whom are excellent and crucial to my staff. We're able to function as a unit very well. It's almost like when you're running the triangle, and if it's not right, it can be really ugly. If it's right, it can be a beautiful way to play the game. The way to run it right is to play with people for a long time so that they already know what you're going to do before you do it. So I have to know who's the best at certain things, like doing triage at the ER.

MT: What kind of communication will you have with the players over the summer?

Vitti: For the first two weeks, I don't talk to them at all, with some exceptions of guys coming in to work out (Christian Eyenga, Darius Morris, World Peace). Kobe and I exchanged a few things, but for the most part, I leave them alone for two weeks, and then I communicate with them at least once a week to find out where they are in the world and what they're doing. They have to do something – not necessarily basketball, but something physical. Tim will probably fly around and check on a few guys, and we also have the draft and summer league to pay attention to. Then we just stay in touch until mid August, when I go on vacation, coinciding with many of the player's last vacations. There's a reason they call it Labor Day in the NBA, because the day after, you really start ramping up to get ready for training camp.

MT: Bynum has obviously had injuries in the past centering on his knees, but made it through this season healthy, missing only one game due to injury. He came in healthy, stayed healthy and is now healthy. Does that give him an advantage next season of staying healthy?

Vitti: Yes. It should. Andrew does have some alignment issues that are apart of his make up, but you try and make him the best that he can be. We worked at it as a staff, and he worked at it, and to his credit, he also played through some things this season that would have sidelined some guys in other years. He needs to be credited for that. He could have easily taken a game or two off due to swelling in his knee, but he did not. He gutted through it.

MT: Andrew suggested that he will go see Dr. Peter Wehling in Germany that performed a procedure (called Orthokine or Regenokine) on Kobe's knee last offseason?

Vitti: I've already spoken to the doctor in Germany regarding Andrew going through the same procedure as Kobe did.

MT: And will Kobe go back to see the Dr. again? Perhaps after the Olympics in London?

Vitti: Yes. He could even do it while he's playing. I'm not sure if he's going to go before, during or after, but he says it helped doing it last offseason.

Editor's note:
click here for Part 2 of our conversation with Gary Vitti, which centers upon the Orthokine and Regenokine treatments performed by Dr. Wehling, including how the idea was first brought to Vitti from a season ticket holder and how the process actually works.