Gary Vitti: Lakers Health Report

How is the compressed NBA schedule physically impacting players' bodies?

To try and understand this question, specifically as it pertains to the Lakers, we enlisted the team's head athletic trainer, Gary Vitti. On the weekend's trip to Milwaukee and Minnesota, Vitti described Kobe Bryant's current status with his wrist, knee and ankle, explained the difference between traumatic and overuse injuries and weighed in on the significance of a truncated training camp:

MT: Is it inaccurate to describe what appears on the surface to be more injuries than in a typical NBA season to the compressed schedule due to the lockout?
Vitti: I think people are looking at things the wrong way if they're suggesting that more injuries are happening just because of a compressed regular season. That's part of it, but the first part is the shortened training camp, and the time that led up to camp. In non-lockout years, by Labor Day, our gym is full – players are coming in, working with us and getting prepared for training camp. Then the camp itself is a preparation for the season, so when we talk about a truncated season, we have to start with a truncated camp and pre-camp. So for this season, we're doing everything on the fly without proper time to prepare. Now, having said all that, what you generally would expect in such circumstances is an increase of overuse injuries, such as tendinitis, bursitis or stress fractures. We've been lucky, knock on wood, so far, to avoid such injuries. We have had the two traumatic injuries with Steve Blake (rib cartilage fracture) and Derrick Caracter (torn meniscus in his knee), but you can't attribute either of those injuries to a truncated season. We do pay very close attention to the volume of work that our players do, and we try to leave it on the court for games, not on the practice court, training sessions or weight room.

MT: I know you can't comment specifically on injuries suffered by players on other teams as you don't have all of the facts that the team's own staff would have, but we have seen a multitude of injuries to players like Dwyane Wade, Derrick Rose and Dirk Nowitzki that would appear to be on the "overuse" side.
Vitti: It doesn't take a genius to figure out that when we have a truncated season, the things we're all most concerned about are overuse injuries. Now, every time you step on the floor, the law of averages goes against you a little more, and if you're fatigued, you might not be able to stable yourself as well to handle that trauma. We have micro trauma, and macro trauma, and if you get on the court once a week instead of five times in seven days, your chances to suffer an injury are lessened. But that's stuff we really can't control for; the only thing we can try to control is the overuse stuff, which we focus on by saving legs as much as possible for games. It's about doing what you can physically and mentally to prepare for gams without overdoing it. That's the best you can do. I wish I had some magical formula, but this is how it is. If you asked me to define how to know when to slow things down, I couldn't, but I know it when I see it.

MT: Along those lines, will there be times when you'll notice something, and suggest to the coaches to back off? And as far as court time, Bryant and Pau Gasol are both way up there among league leaders in minutes played.
Vitti: I haven't had to do that this season. Mike (Brown) is a pretty bright coach. But I do go out and watch parts of practice when I get a chance, but I can get spread pretty thin between the court, the training room, the weight room and the locker room. Mike is great to work with, and I can always talk to him about things, probably more so regarding practices than games. But my game philosophy, whether we are up big or down big, is get the money off the floor.

MT: Prior to the season, you told us that you and your staff were fully behind Kobe Bryant's trip to Germany for innovative work on his knee, to the point that you encouraged it. It's been pretty clear to anyone watching that he really does look much better physically this year than he did in the past few, despite his injured wrist.
Vitti: He's very, very special. His approach to the game mentally and physically is second to none, literally. He prepares himself mentally and physically, and has an ability to focus on the task of playing basketball – part of that is going to a place like Germany to get a procedure done that he and we had confidence in, and taking the time, the energy and the expense to do it. He's phenomenal. I can't imagine what kind of numbers he'd be posting if he didn't have the wrist injury. That's what's holding him back, not the knee or the ankle.

MT: How should tearing ligaments in one's dominant wrist affect a player?
Vitti: It's his shooting hand, so it can't get much worse. The wrist is stable, even though he tore the ligament, but there is swelling, there is pain and he's lost range of motion. He works constantly to try and get whatever strength he can, as much range of motion as he can and make the adjustments for what he can't do physically. He's so strong-minded that he's able to do that. He just figures it out. 'If I do this – turn a little bit this way or that way or follow through a little bit less – I can still get the shot off with this much accuracy.'

MT: Kobe first told a reporter (the Orange County Register's Kevin Ding) after game at Utah on Jan. 11 that his wrist was starting to feel better. Is this the type of injury that does get better and fully heal?
Vitti: Yes. Eventually it will fully heal. The kind of trauma that's done to it can slow it down, but eventually it will. It's getting better. A week like this (with only three games) can help that. It helps that he does the due diligence with his unique preparation. When he steps onto the floor, Kobe Bryant is prepared to play in every way, better than anyone I've ever met.

MT: Though he seems to be better now, Pau Gasol had been dealing with a sprained shoulder. He removed the brace a few games ago?

Vitti: It was more of a pad than a brace, with a custom made shirt supporting the pad to fit right over his AC joint. He's now played (four) games without it. It's the type of injury you want to protect yourself from, but you can't really control for running into picks, for example. It's all going to hurt. Some people grimace and bear it better than others – Pau did OK with it, and I was proud of him.

MT: Andrew Bynum came into this season healthier then he's been in recent years. How is he holding up physically, from your perspective?
Vitti: He looks much better than season's past. As everyone knows, he has some issues, but what you can do is try to minimize those things, which so far he's done a good job with. Right now, we feel pretty confident about how he's doing. January has always been his bad month, but he crossed the milestone of playing Memphis in January and getting through the game.


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