Lakers training staff's duties go well beyond taping ankles

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EL SEGUNDO, Calif. -- Athletic trainers may be best known for taping ankles, but Gary Vitti and his team’s laundry list of duties is far more comprehensive, complicated – even clinical – to keep this season’s injury-riddled Lakers team together.

“Taping ankles is probably the least thing that we do, but it’s the most recognizable thing,” said Vitti in an exclusive interview with Time Warner Cable SportsNet at the team’s practice facility.

His staff of six – himself as the head athletic trainer of nearly 30 years, physical therapist Dr. Judy Seto, his assistant athletic director, a full-time massage therapist, a head strength and conditioning coach and an equipment manager – have their hands full in the training room.

“We do a lot of manual therapy in our training room, meaning your hands are actually on somebody and you’re moving bones around,” Vitti explained. “You’re mobilizing joints and you’re mobilizing soft tissue and we even do that during the game sometimes.”

Vitti figures that with every step, running or jumping, players take a pounding to their joints of about four times their body weight. For ‘high flyers’, impact to the body is more traumatic and they are even more susceptible to their pelvis rotating forward. This change in posture can cause pain, so training staffers constantly try to rotate the pelvis back to a neutral position through core strengthening.

“If we can do that, we can minimize the angst and pain and the hamstring sores, the foot sores, the back sores,” Vitti said.

Delayed onset muscle soreness, a common minor injury caused by micro tearing of muscle fibers, can be remedied with cold treatments and contrast, going from 55-102 degrees.

To get guys ready to play, training staff first apply cryotherapy, or ice, to cause blood vessels to constrict, then heat to cause them to expand. Greater vasodilation, the widening of blood vessels, brings more blood flow and nutrients to an injured area for healing.

After a game, it’s strictly cold. Especially with acute injuries, ice reduces blood flow to the area to keep swelling down and slows down the metabolic rate of cells around an injury that would die of hypoxia, the lack of oxygen. It explains why Kobe Bryant soaks his feet in a tub of ice and Dwight Howard gets ice wrapped around his shoulder postgame.

“If you ask any athlete, they’ll always choose to ice after they’ve competed or after they’ve been injured,” Vitti said. “All these are clinical in nature as opposed to science, but they seem to work.”

In addition to postgame cold treatment being common, a cryotherapy chamber inside the practice facility allows players to immerse as much as their whole body in cold water.

While contrast pregame and ice postgame may be the standard, players are different and the sports medicine staffers try to find treatments that work for each individual. They might start with one routine and as the player gets better, do less treatment and more maintenance.

Different training programs for each player

“If you have 14 or 15 players on your team, you should have for the most part 14 or 15 different training programs because not everything works for the other guy,” Vitti said. “You’ve got to find out what makes this guy click and then you work that.”

With Steve Nash, Dwight Howard, Kobe Bryant, Pau Gasol, Metta World Peace, Steve Blake, Jordan Hill and Earl Clark all injured at some point and in varying degrees this season, these individual training programs have been anything but simple.

“It’s almost impossible to go through the NBA season, even if you’re not in the rotation, without having something that requires you to come into the training room,” Vitti said.

Prevention, according to Vitti, begins with an exit physical at the end of every season, and predisposing factors to injury are corrected during the off-season.

The training room is always full, but recently it’s been full with guys who are now playing.

World Peace and Hill may be out due to surgery, but Gasol is back from his torn plantar fascia, Bryant is playing through a bone spur, Howard continues despite his shoulder strain, Blake has been back from abdominal surgery and Clark pushes forward with a foot injury.

“For a while there, we just couldn’t keep anybody on the floor. Some guy would get well and somebody else would get hurt,” Vitti said. “So right now, knock on wood, we’re healthier than we were most of the season.”

In some instances, Vitti's staff is tasked with working magic to get a player on the floor.

When Bryant severely sprained his left ankle by landing on Dahntay Jones' foot against the Atlanta Hawks on March 13, many thought he would be out for an extended period. Using his Twitter account @kobebryant, he tweeted a photo the next day of hands on his ankle and "Ankle still very swollen. Treatment all day #focus."

Round-the-clock treatment from Dr. Seto was critical in enabling him to play the first quarter of the Indiana Pacers game just two days after the injury.

Despite the many treatments at odd hours that he and his staff constantly administer, Vitti refuses to take the spotlight.

“I think all the credit must go to the players,” he said. “In the end, no matter what we do, they still have to be the ones that go out there and play, so I would never take credit for that.”

You can follow Jessica Kwong on Twitter at @JessicaGKwong.

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