L.A.'s Secret Weapon

How good is Lakers head physical therapist Dr. Judy Seto at her job? Suffice to say Kobe Bryant doesn't much like to talk about it, for fear of revealing what's little known in the public but accepted as fact in the medical community.

Bryant and his teammates want Dr. Seto all to themselves. Indeed, at one point of the 2011-12 season when Bryant was battling myriad injuries, I asked him how much of a difference Dr. Seto made.

"Enormous," he said, keeping it short, sweet and guarded. "It's really huge."

Seto recalled the 2008 Olympics in Beijing, when Bryant had Seto by his side throughout Team USA's gold medal run. When Pau Gasol found out she was there, he wondered why Bryant hadn't disclosed the info. "Because you play for Spain," said Bryant.

LAL's PT is currently at the London Olympics with Bryant ... we'll see if Kobe tells Gasol this time.

Dr. Seto has been working with the Lakers on some level for roughly 20 years, rehabilitating injuries of various players initially at the internationally renowned Kerlan-Jobe Orthopedic Clinic and most recently at Select Physical Therapy in Los Angeles. In the past several years she's expanded her role to traveling with the team throughout the playoffs. Dr. Seto first started working with Bryant when he hurt his ankle in the early 2000's.

Bryant, more particular about his body than anyone, values Dr. Seto's ability to understand and work through his entire kinetic chain. He -- along with head athletic trainer Gary Vitti -- wound up playing a key role in convincing her to come on full time for a 2011-12 season the Lakers completed without a single injury heading into the summer.

Dr. Seto's resume isn't short: Bachelor of Science in Kinesiology & Psychology at UCLA; Masters in PT at Stanford; Doctorate in PT at Temple University; Board Certified Sports Clinical Specialist (SCS); Board Certified Orthopedic Specialist (OCS); MBA; and Certified Strength & Conditioning Specialist (CSCS).

"It's not the initials that makes someone more knowledgeable," said Dr. Seto. "It doesn't make you smarter ... but trying to improve your knowledge base is always crucial."

We joined Dr. Seto inside her training room office to delve deeply into what it takes to do her job, why it's important to NBA players, the psyche and body of Bryant and more:

MT: When did you first decide to become a physical therapist?
Dr. Seto: When I was a freshman at UCLA, my friend's father had a stroke. I went to visit him in the hospital, and ended up asking his physical therapist a series of questions about the job. I kept that in my mind and then as a pre-med student as a junior, and thanks in part to some volunteer work I was eventually offered a job at Daniel Freeman Hospital in Inglewood as an aide. There I learned about all sorts of different specialties within physical therapy. Sports medicine is such a hot specialty area in the field, but there are so many other areas: stroke; heard trauma; spinal cord; and so on. That gives you a good appreciation for what's out there. I remember doing some volunteer work at a UCLA prosthetic and orthodic program with kids who were missing limbs, and trying to figure out how to teach a kid with no legs how to walk. The amazing thing was that they really put an emphasis on treating everyone like a normal kid, which they were. Things like that made it really interesting to me.

MT: How did your relationship with the Lakers first begin?
Dr. Seto: I've been working with the Lakers for 20 years or more. I remember working with Jerry West early on in my career. If I didn't do a good job or get positive results with Jerry, that probably would impact how many future Lakers I'd see. It mushroomed from there. One thing that stands out about Jerry was him asking me, on a scale of 1-10, how I'd rank myself as a physical therapist. I knew I was better than average, but didn't want to sound arrogant and knew I still had a lot to learn, so I said "six." I was trying to be humble to a degree, but I just thought if I said I was a 10, there would be nowhere to go and imply I had learned everything. He quipped, "Then why am I seeing you?"

MT: So candid from Mr. Clutch! How did your relationship begin and evolve with Bryant?
Dr. Seto: He sprained his ankle at some point in the late 1990's. You know Kobe well enough to know that if he doesn't trust you, it's over. Right away. He's never going to trust you.

MT: No doubt.
Dr. Seto: You only have one shot with him, and if it didn't work out from the beginning, I probably wouldn't be sitting here right now. If there was a lack of trust not only with him and other players, the team doctors and so on, that would have been it. And Kobe particularly doesn't just give trust, you have to earn it. From my point of view, the best way to earn his trust is to know what you're talking about. He's seeing me for a reason: how I can help him be a better basketball player. If I couldn't help him, he wouldn't come back. He's also the type of person that if you are saying things you think he wants to hear and are just a 'yes' person, he will not respect you. I think he picks up on that very quickly.
Editor's Note: Stay tuned for more specifically on Kobe from Dr. Seto in Part 2 of this interview later this week.

MT: Being able to have such an impact on a pro sports team is something that I'm sure interests a lot of folks in or looking to get into PT. What do you tell those that inquire?
Dr. Seto: People always ask me how I got started, saying that they want to work with pro athletes. But no one just jumps into doing this. You have to prove yourself. The Kerlan-Jobe doctors work with many athletes, and they're not just going to hand someone over who is unproven when there's a lot at stake. So when you first begin at the clinic, you might start working with recreational or high school athletes, some college or semi-pro, and gain the athletes' and doctors' trust. At a certain point you might get a pro athlete and the doctors and teams see how you do. If that relationship or treatment isn't good, why would they send you another player? But as they start to trust you more and more, you get a reputation of being able to produce good outcomes for athletes. This type of professional relationship grows naturally, and isn't something you can demand.

MT: You're always talking about the alignment of the kinetic chain. Is Metta World Peace in 2011-12 a good example of how different body parts impact one another?
Dr. Seto: That's a very good example; he was having back issues last summer and didn't have his explosiveness, and we realized the problem went back a few years. When we examined his lack of muscle flexibility, compensatory patterns and muscle imbalance, and how that affected his explosiveness and power, it was clear something needed to change. He was having a problem with his vertical jump and his quickness, so it'd be easy to focus just on his legs. But that's not where the foundation is. That's from his alignment in the core. If your alignment is not in place, you can't generate enough power because your foundation is faulty. You just don't have enough stability, so now, when you look at how he was playing towards the end of the season when he was quick again, his vertical jumping ability was there and his legs weren't feeling heavy, it wasn't just because we worked on his legs. We incorporation his alignment in the core from the outset. That reflected in his performance on the floor.

MT: Word is that the players are pretty protective of you in the locker room?
Dr. Seto: Just by being around the players and coaches every day, you become part of the camaraderie that goes along with it. I'm fortunate that the players really don't give me a hard time mainly because they need me. An example: (assistant coach) Chuck Person came in the training room, and he gave me a forearm shiver in the shoulder. And I said, 'What was that for?' He said, 'You're part of the team now!' I said, 'No, you can't do that.' So I asked Pau and (Matt) Barnes to weigh in, and they said, 'No, that's Judy - you can't touch her.' Chuck was going, 'OK, that's how it is?' And they nodded, 'Yes, that's how it is.' Then I told Chuck, something's going to happen some day where you're going to need something from me, and you don't want to be on my bad side by giving me forearm shots. He agreed. So they have my back.

MT: There's nothing more important to a professional athlete than his body, so that puts trainers and physical therapists in a unique place of value...:
Dr. Seto: We're the ones that are responsible for their health every single day. We have to have their trust and confidence, and we have to be able to figure out what's going on and step up and solve their problem. And if we don't get them better, why are we here? They are the collective face of the organization, and we have to keep them healthy so they can do their job.

MT: Aside from Kobe probably begging you all summer, what went into you coming on full time this season and what was different about that?
Dr. Seto: One of the biggest changes is that I got to see the players every day, and they got to see me too, so if anything happened, we could address it right away. In previous seasons where I was only in once in a while, maybe certain players wanted continuity and would thus wait until I was able to come in to address something. This season, I could work with Gary and the entire training staff to address things sooner and keep problems at a very minor level instead of having an early injury grow and impact other areas of the body. It takes time to learn about each player's body, and because I'm here every day working as a member of the training staff, we know their history and I can quickly resolve any problems. The players and coaches see all of us here every day and trust us, which helps build a more cohesive team.

MT: Let's talk more specifically about treating NBA players. How much does time, or lack there of, make an impact?
Dr. Seto: Often times there simply isn't any time. Things happen quickly. A good example is when Kobe suffered a concussion at the All-Star game. It's not often recognizedthat such impact can also create whiplash-like symptoms, but it turned out to be just as limiting for Kobe as the concussion. It wasn't so much the concussion only but the whiplash affect influencing the concussions testing, and if we hadn't recognized that quickly, Kobe wouldn't have been able to return to play so quickly. We don't have the leisure of time very often. You have to think really quickly on your feet. You don't have time to be wrong.

MT: One more example?
Dr. Seto: During the 2009 playoffs when we were playing Denver and Trevor Ariza had back issues, I basically had halftime to try and figure out how to get him onto the court. He had to go play. That's pressure.

MT: Are 7-footers any more susceptible to injury based on having more length/mass?
Seto: Not necessarily. It's all about proportion in one's anatomy. The loads are going to be different for a player based on their height and mass, but that doesn't always tie into risk factors. I often look at players like cars. In order for a car to run smoothly, it needs all the pieces to work together. But when you're fixing up a sleek Porshe convertible instead of an Escalade SUV, you're looking at two different functions. The demands are different. The SUV is built for power, the Porshe for speed. And if you understand that, it makes it easier to understand how to fix the car and make it run smoothly. Your guards are going to have different skills and movement patterns than forwards and centers. The job demands are different. If you're asking them to do things specific to their body and position it should be OK if they are functioning at an optimum level. Look at the Indy 500 … a whole pit crew is there to make a car run well on that day. I kid these guys that when they come in, I have to give them a 27-point inspection. There are certain factors I'll check for with each player, just like an Indy car. The pit crew is trying to prevent things from happening, and make the car run smoothly before it goes onto the course. It's the same for us. Before players get onto the court we have to keeping them running smoothly at the highest possible level.

MT: Well, in your first full season, no Lakers missed significant time, and nobody left exit physicals with an injury, which is rare especially in the lockout compressed season.
Dr. Seto: I think everyone on Gary's staff works well together, and with lines of communication open we can often nip things in the bud before they become an issue. We see trends happening, trade notes, and exchange ideas. For example, we see tightness somewhere we then have that player do the appropriate thing to make sure it doesn't become a strain or a tear.

MT: Do you get a high off seeing a player on the court that probably wouldn't be playing had you not figured something out in his rehab?
Dr. Seto: That's probably the part that is the most fun with this position. The challenge is in getting this level of athlete to the highest level of his game in a timely fashion, and without an injury cutting short his time. It's not an easy thing to do.

MT: How important is attitude towards rehabilitation?
Dr. Seto: Getting a degree in psychology proved to be extremely helpful in giving credence to the fact that the mental side of things is so important. How you approach an injury really impacts the actual healing process and how well people come back from their injury. It can take a guy with a great attitude a shorter period of time to get better than it might someone with a negative attitude; those things really matter. Focusing on the future can be really important, and takes so much less energy from someone that has a negative thought process. That's something the entire staff has to constantly address in the training room -- at least indirectly -- with players who are injured and aren't used to dealing with injuries, because they've never had such limitations. So keeping them as positive as we can helps move things along more quickly.

MT: You spent some time with Mike Brown last summer before taking the position, right?
Seto: Correct. He'd just been hired, and I remember meeting him at a Starbucks. Mitch (Kupchak) wanted us to meet, and for Mike to be comfortable with me. Mitch figured it'd just be a 15-minute thing, but we ended up talking for two hours about training philosophies and approaches, why we both were excited about joining the Lakers and so on. That made my decision a lot easier, having the head coach saying he wants you on board.

MT: The way things are, some player's bodies (i.e. Kobe) are worth more than others (the 15th man). Do you try to avoid thinking about people in such terms or is it inevitable at all given how much time an athlete gets at the head table in your care?
Dr. Seto: We can't take the time to stress about how much a player's body is worth. I'm not going to treat someone who makes less money differently from how I would someone who makes the most money. I have to give everyone the same expertise of care, whether with the Lakers or at the clinic with a high school athlete. With that said, the stakes are certainly higher for a pro athlete; it's part of the job demand that they're returning to.

MT: Have you been getting more 'Who is that?' looks of late? You get a lot of TV time.
Dr. Seto: One of the flight attendants that flies the team had a friend ask her, 'Who's that woman who is sitting behind the Lakers bench? Is that a season ticket holder? She must be pretty wealthy to have that seat, especially on the road?' Someone else thought I was Kobe's psychologist.

MT: Because some people aren't used to seeing women behind the bench, where the team doctors and training staff sit?
Dr. Seto: Right, it's not fathomable for some people to think there are females working with NBA teams. It isn't common. I think Houston had a female assistant trainer at one point but I don't think there is any longer. I'm the only full time female physical therapist with an NBA team. But the players don't care if you're male or female, not at all. If you can help them, you're the person.

MT: What does being the only woman working full-time with a training staff in the NBA mean to you?
Dr. Seto: It's refreshing to know that people are asking me how I got my job, but they're not just asking me what it's like to be a woman in the NBA. They want to know about my expertise. That shows progress from where the position was, as barriers continue to be broken down, and perceptions change about women working in sports medicine. I remember my first supervisor telling me that because you're a female in the sports medicine world, you have to be 10 times better than the guy next to you to be thought of in the same light. That's just the reality of how it was … and I think he was right. It's not something that you wish for, but you can't change people's perceptions immediately. Now, as long as you're good at what you do, doctors and athletes could care less about you being male or female. Because I've worked with a lot of teams in various sports, they now just send me people because of my track record. And I certainly don't take it for granted that the Lakers have added a full time physical therapist because it's not role traditionally a part of a professional team's training staff though that is gradually changing.

MT: What are the benefits of having a full-time physical therapist with the team, of identifying and treating problems in advance?
Dr. Seto: I was talking to a trainer who was working with an athlete who had a broken bone in his foot that required a pin through surgery. The person had to have a second surgery because it broke again in exactly the same place. And I said, if you don't change the way you're loading the muscles on that foot from other areas, it's just going to happen again. Most of the time, the hardware won't give, you have to relieve that pressure in the first place. So that's what we're trying to do here: catch and address issues before they actually become full time, problematic injuries.