By Leigh Ann Simpson
Every year college basketball fans across the country work themselves into a frenzy, commonly referred to as March Madness. Friends, coworkers and even enemies arrange their brackets and put their money down on the teams they think are most likely to win the National Collegiate Athletic Association (NCAA) tournament – usually generating a list of who’s who in college basketball. Regardless of which team you pull for, odds are that Duke University is somewhere on your list of the major contenders. Statistically speaking this isn’t a surprise considering their impressive legacy with four national championships as well as 19 Atlantic Coast Conference (ACC) championships: it’s safe to conclude that the men’s basketball program at Duke is one of the best in the country.
Such success doesn’t come easy; it requires diligence, dedication and most of all, maximum performance from each player during every practice, game and throughout the year. The task of providing such an enormous amount exceptional health care to an entire team (who are pushing themselves to their physical limits and risking injury on a daily basis) should not be assigned to the faint of heart. So who is in charge of maintaining and improving the health of these champions? For the past eight years, Jose Fonseca, BS, MA, athletic trainer for the Duke University men’s basketball team has successfully undertaken this challenge. During our exclusive interview with Fonseca, we learned what it takes to keep these play ers running like well oiled machines.
Each player is given three biomechanical assessments at the beginning, middle and end of the year. The results are tailored into a customized preventative medicine program designed to correct whatever physical concerns a player is having and reduce the likelihood of injury in the future. “If a player has a limited range of motion, we try to increase their range of motion; if they have muscular weaknesses, we try to increase their strength; if they have an incorrect firing pattern, we try to correct their firing pattern.” With the help of Nick Potter, BS, DPT, assistant director of athletic rehabilitation, a preventative medicine program is designed and used as a reference for each player based on the results of their individual assessment. Fonseca and Potter work closely with Duke University’s strength coach, William Stevens, CSCS, who also uses this preventative medicine program during the players’ strength and conditioning training. The goal of the program is to work with each player; focusing on their individual health concerns to optimize their physical ability and keep them from getting hurt.
When it’s game time
During basketball season, Fonseca explains, the team practices every afternoon, with the pre-practice process starting about an hour before the actual practice begins. For the players who are not injured, athletic trainers work on prevention treatment; some get their ankles taped; some are stretched and work with Potter on physical therapy or manipulations on their back before going onto the court. If a player has an injury (recent or ongoing) they meet with athletic trainers in the morning before their classes for physical therapy treatments and have their injury assessed to determine if they are able to practice that day or not.
Fonseca writes an injury report based on his evaluations and sends it to the coaches by late morning. This lets the coaches know who will, and who will not be practicing that day, or if a player will be practicing with some sort of limitation, so that they can plan their practice accordingly and be able to get the most out of each player that day. “So what injuries keep these guys out of practice?” we asked Fonseca. “There are definitely some absolutes – if they have a break or a swollen knee,” he says. “But for the most part (my decision) is based on if I feel that a person can protect themselves on the basketball court and function at a high level.”
Upon walking into the training room at Duke, you’ll find what you would expect; a few exam tables, athletes being worked with, along with various medical devices etc… However, Fonseca showed us the training room’s most recent state-of-the-art addition. “Last summer, Coach (Mike Krzyzewski, head coach of Duke University’s men’s basketball team) provided me with a very nice gift,” says Fonseca. “He allowed me to renovate the training room.” The gift was approximately $800,000 for the renovation project that was completed last December. Today the room has three large aquatic training tools; a cold plunge, a hot tub and a therapy pool. The cold plunge is set to about 50 degrees Fahrenheit and is used after practice to help with sore ankles, knees and muscles. The hot tub is kept at approximately 104 degrees Fahrenheit and is used before games to loosen muscles, increase flexibility and allows the players to relax. Both the cold plunge and the hot tub can accommodate nearly ten players and are even equipped with a television for the players to watch while soaking. “Yeah, before and after games you’ll have eight, nine, ten of the guys in here hooting and hollering,” says Fonseca jokingly.
The third is a therapy pool, with a floor that is actually a treadmill and has served as a crucial rehabilitation tool during several injured athletes’ recovery processes. The height of the floor controls the water level in the treadmill-pool and can be adjusted based on the height of the player and how much weight a player needs to support on their ankle, knee or foot. “So if you’re a six foot tall guy and I don’t want to put any weight on your foot, I will lower the floor all the way down so that your head is just barely above water, or just a bit below, so you’re just floating as your running and there is less pounding going on in your joints,” Fonseca explains. “Then as you (the player) get(s) stronger, I’ll raise you (the player) up so that you’ll feel more true weight.” Once the player reaches a point they can put weight on their ankle, knee or foot they continue their therapy running on a regular treadmill until they are able to play – allowing a seamless transition back onto the basketball court. The pool is also equipped with jets that can be used for additional resistance while the player is submerged. Two cameras, located within the pool, film the front and side view allowing athletic trainers to observe and record the players as they run. Data and images from each training session are stored on a computer and can be referenced by other athletic trainers to continue monitoring the progress of the player, regardless of which athletic trainer they’re working with that day.
An essential bond
Trust is absolutely paramount in the relationship between a player and their athletic trainer. Fonseca is aware of the vital role that he plays in the lives of these young athletes; he makes the call on who plays and who stands on the sidelines. Many of these players are hoping to pursue a professional career in basketball – a dream that can be easily thrown away by a severe injury. However, on the other side of that argument, the players want and need to play in order to gain exposure and impress NBA recruiters. “I would never put in an injury report saying that a player is out without explaining what is going on with them and give them all the exact details,’ says Fonseca. “So it’s kind of like this ongoing revolving wheel that we are (athletic trainers and players) always in great communication with each other, asking each other ‘what can I do today, what can I not do today,’ to try to find a happy medium.”
Fonseca explains that being an athletic trainer is much more than monitoring an athlete’s physical health. They must know each player very personally so that they can read them, especially in critical situations involving their health. Their intuition has to be dead on so that they can pick up on exactly how they are feeling – regardless of how they say they are feeling. Fonseca has become so connected with his team, that not only does he know when a player is too injured to play, but also when they are able to play, even when the player’s confidence is shaken. Recently, Fonseca proved his ability to do this during a match up between Duke and North Carolina State University (NCSU) on Feb. 16, 2012. During the first minute of the game, Duke junior, Seth Curry, suffered an ankle injury that he and Krzyzewski thought would take him out of the game. After surveying the injury and knowing Curry’s level of strength and ability, Fonseca not only cleared Curry to play, he didn’t leave him a choice: “You have to go,” he said. With the order from his athletic trainer, Curry returned to score an amazing 21 points during the second half, leading Duke to a victory over NCSU and making Curry the hero of the game. If Fonseca hadn’t given Curry the clearance and the confidence that night in the locker room, he probably would have not returned to the game to save the day – making Fonseca a hero’s hero.