During a typical NBA campaign, Dr. Kristofer Jones, the Lakers Head Team Physician and Director of Orthopaedic Surgery, would be focusing on knees, shoulders and elbows.
But when the COVID-19 pandemic caused the suspension of the league in March, Dr. Jones and a team of UCLA Health physicians got to work to help provide the Lakers with as much assistance as possible in managing the situation.
As an All-Conference running back at the University of Chicago prior to his medical training at the University of Pennsylvania and residency at the Hospital for Special Surgery (HSS) in New York City, Dr. Jones understands concerns of athletes about maintaining their health.
In fact, prior to joining UCLA Health and the Lakers, Dr. Jones worked with the Brooklyn Nets, New York Red Bulls, the United States Tennis Association and the US Open Tennis Tournament.
He joined us over the phone to discuss his day-to-day interaction with the Lakers about COVID-19, to share the importance of maintaining social distancing and wearing masks, to discuss the best practices for gatherings to watch Lakers playoff games and more. Below is a transcript of our conversation:
MT: Hey Dr. Jones, before we spend some time discussing the pandemic and how it applies to the Lakers and the NBA, can you give us some background about how being an athlete yourself helps you do your job?
Dr. Jones: Absolutely: If you were to ask a lot of sports medicine physicians at some point along their trajectory, they had some type of sports injury that introduced them to the field of orthopedics and sports medicine. Mine came from a shoulder injury that I had playing high school football. I grew up in Chicago and saw one of the physicians for the Chicago Bears, and going through that whole injury process and the surgery, recovery and rehabilitation, it was a natural fit for me. So to call back to that experience as I treat these guys, I know what they’re going through and the anxiety that comes along with a return to play. We have the team aspect of it as well in working with (Lakers Director of Sports Performance) Dr. Judy Seto and some of our performance staff in having a comprehensive approach with physical rehabilitation, physical therapy and athletic training.
MT: Although you specialize in orthopedics, I’d assume it’s an all-hands-on-deck approach during the COVID-19 pandemic, so I wonder what it’s like for you medically at UCLA Health at the moment?
Dr. Jones: All non-essential surgeries were shut down in March when we were concerned about the hospitals seeing surges. Gradually we got that under control here in L.A., with the response of Mayor Garcetti and Governor Newsom. It really helped us to keep it at a place where it was manageable here in California after seeing what some of our colleagues went through in New York, which was an untenable situation. At UCLA, as things got better, we started to open up non-essential surgeries again, so I’m seeing patients and (performing surgeries) again. But for those patients who don’t feel comfortable coming to the hospital, UCLA has done a great job at setting up a telemedicine option for those that want to stay home or have to go to work, and I’ve been shocked at how much I’m able to accomplish over the phone with a patient and initiate a treatment plan.
MT: How about specifically with the Lakers in your role as the Team Physician?
Dr. Jones: Ironically, it’s been busier than ever. I’ve been in contact with our front office, (VP of Basketall Ops/GM Rob Pelinka and (Sr. Basketball Advisor) Kurt Rambis, on a daily basis in some way or another, whether through a phone call, Zoom call or e-mail. It’s taken an incredible amount of coordination on the part of the Lakers to come up with a plan to get things going in anticipation for the ultimate ramp up towards the bubble in Orlando. We knew at some point there was going to be the potential for getting back to play, so we didn’t want to just wait for guidelines from the NBA and local government. We instituted a lot of things on our own because our front office was so proactive, and so driven to be at the forefront of this. We were one of the first teams to really take a comprehensive approach to testing our guys when we knew there was an exposure, so it’s been a constant line of communication between myself, our team internist Dr. Daniel Vigil, our performance staff and the front office.
MT: What’s the process been like for you coordinating with the Lakers players and staff about the virus?
Dr. Jones: First and foremost, our primary objective was education. It’s hard to really institute something that changes your day-to-day life so drastically without understanding why. It’s pretty clear, and we’ve been dealing with this for a while now, that we have a sense of what this virus is. But in terms of how it affects people who are asymptomatic and could spread it to others, I think that’s the hardest part to grasp, and why we’ve seen things like mask wearing and other issues around the virus become somewhat contentious and politicized. From my standpoint, we’ve hopped on phone calls with the team to talk to the group about the basic things we need to understand about the virus and the things we can do to mitigate the spread, not only in the UCLA Health Training Center, but also in our daily routines to keep our families safe. We all have loved ones, small children, older parents that we’re trying to look out for. So it’s about getting some buy-in. I try to be really objective with data with these guys, who are numbers driven, being in sports. I try to give guys examples that are applicable to their real lives, and also relay real-time data as we try to understand this virus even more.
MT: Just to go back to the basics, what can you relay about the virus and how we can best be doing our part to prevent the spread?
Dr. Jones: The novel Coronavirus, COVID-19, is a respiratory virus that is spread through air droplets. We know that it is highly virulent, meaning highly contagious, and based on what we’re seeing (data wise) coming out of China and now the United States, we know that there’s some very basic things we can do to try and mitigate the spread. Number one would be social distancing. Just making sure that when you’re in the presence of other individuals, staying at least six feet away from that person. The other mitigating source would be what we call source control: wearing a mask. People are walking around asymptomatic with this virus with no symptoms whatsoever, but they’re highly contagious. That tends to be the younger demographic, and our players and a lot of our staff fall into that group. By wearing a mask, what you’re doing is protecting other people around you – it’s the most selfless thing we can do to try and keep this virus from spreading in a way that we see the pandemic or the number of cases get out of control. And then, there are simple things like washing your hands.
MT: Is it fair to say that’s it’s really important for us to do our own part here as doctors and scientists work towards a vaccine, to try and buy time?
Dr. Jones: Exactly. Vaccines can take years to get something that’s effective to preventing the spread of any disease. I think we’re probably looking at least another year before we have anything we can use to prevent community spread. People in labs are working pretty feverishly to try and get that, and I think we’re going to see a vaccine the fastest that we’ve ever seen become available. The threat is real, and people are working to try and get a vaccine that may be helpful.
MT: I know Lakers fans are super excited to have games back starting on July 30; what are a few guidelines to keep in mind if people are wanting to organize small gatherings to watch games?
Dr. Jones: If you’re fortunate enough to live here in Southern California where it’s always nice, having gatherings outside can certainly help mitigate spread. Whether that’s in your backyard or your garage with the door open, something where you’re getting some type of ventilation and air flow throughout the space. Social distancing is obviously very important; keeping the chairs six feet apart, and then wearing masks, and wearing them the right way. The mask needs to cover your mouth and your nose, not one or the other. I’d also say if you can, keep the gatherings to small groups of people that you know have been social distancing. Just a group you’re familiar with and you know they’ve been smart about keeping the virus at bay.
MT: Moving back to your expertise as an orthopedist, what are the best ways you and the Lakers performance staff led by Dr. Seto aim to mitigate injuries heading into a unique circumstance in Orlando, taking COVID-19 aside for a moment?
Dr. Jones: As an orthopedic surgeon, that’s probably one of my main concerns. We’ve seen how this plays out post lockouts in various sports. We initially see a pretty dramatic increase in what we’d call core-conditioning types of injuries, your muscle strains and ligament sprains, hip flexors, lower back strains. A lot of our guys tend to have back issues early on in the season that we have to work with. And as conditioning ramps up throughout the season, we start to see those things go away. I think what you need to realize too is that it’s not just about what we do with them on the court or during practice as they condition, but it’s just the season itself as its own form of conditioning as they get back to playing NBA basketball. It’s the body getting used to that load again. So, we have baseline functional data on all of our guys that we get on all of our guys preseason, so we have a sense of where they are coming in. We have a really good electronic medical performance database we can call on to see where a guy is in terms of his conditioning, and really tailor the ramp up to that particular player. We’re going to treat our 33-year-old veteran differently than our 21-year-old 2-way guy. Everybody is different in terms of how they approach their ramp up. Going into this, I’m mostly worried about those types of injuries, but I guess the good news is those are injuries you can certainly work through and aren’t career threatening for the most part.
MT: I’ll knock on wood here, but does it give you additional confidence that this is a team mostly composed of veterans that have been through all kinds of NBA experiences, and led by LeBron James, are going to know their own bodies better than young guys would?
Dr. Jones: Yes, because those are guys that have been through these types of lockout seasons, those are guys that have gone through season after season where they have this sort of pattern. You’re in your offseason, you put it on cruise control in terms of your conditioning, and then you know when and how to turn it on to get your body used to load. Then you’re able to ramp it up as the season progresses. You get a sense after doing it for several years what your body needs. This is a little different approaching the bubble, but I think you can apply those same principals to the bubble in a way that tries to mitigate the circumstances.
MT: What’s the key with your communication with Dr. Judy Seto and her staff on the athletic training side?
Dr. Jones: Our communication is on a daily basis, what can you do from a performance standpoint to keep guys conditioned at home, making sure they’re on top of their nutrition. We’ve added some things to guys’ diets just based on what we know their bodies are going through physiologically when they’re not playing NBA basketball, (substances) we know as we get back to play that can mitigate some of those strains and sprains that we see. Just various things that have some data behind it.
MT: What have we learned medically about COVID-19 and the data on potential for return to play after contracting it?
Dr. Jones: I think that’s one of the harder things to really manage right now at least in the NBA population. We know guys have contracted the virus, but a lot of these guys have been asymptomatic. They’re young, healthy guys who aren’t necessarily showing the same types of symptoms that we’re seeing play out in the media in New York and Texas and so on, so it’s hard to reconcile the two. But we do know from the general population what the post viral manifestations are affecting of the pulmonary system and some types of fibrosis or scarring of the lungs from the low level, or sometimes severe pneumonia you can get. For (potential) cardiac manifestations, we look at the way the virus effects the heart, we have (players) see our cardiac guys and have them get an echo, to make sure that the heart is working properly, and we get EKG’s to make sure there are no manifestations and abnormalities in the way that the heart is conducting a signal to operate properly.
MT: The bottom line appears to be that there are a lot of experts making sure the players are as safe as possible.
Dr. Jones: Yeah, these guys are getting more tests than they want. It’s funny, the other day, one of the players said, ‘Again?’ prior to a routine check.
MT: How much can it help to have guys like LeBron wearing a mask, as we’ve seen him do at the practice facility?
Dr. Jones: Once again, we’re trying to target the younger demographic that tends to be the one that’s more asymptomatic with a higher viral load spreading it to people that have more (vulnerabilities). That demographic can be more likely to be influenced seeing our celebrities and athletes of prominence buying into the mask wearing and social distancing. I think it’s important to have those pictures out there to help change the way we look at it, and having LeBron or AD doing it is only going to help.
MT: Anything else you’d like to share Doc?
Dr. Jones: We were on a call with the NBA getting a sense of what the bubble is going to look like, and man, they’ve gone through every single scenario you can think of to try and make this the safest environment possible. I’ve been amazed at how this has evolved over the last 6-8 weeks, where at that time, we might have said, ‘How is this possible?’ But the NBA has really done a great job of consulting with local experts and creating this little biosphere where players and staff who are going to be there can really feel safe about going back and participating. I’ve been amazed at how this has evolved, and the NBA certainly deserves some kudos and pats on the back for going through such a Herculean effort to get this done.