The Sacramento Kings are ramping up for their upcoming season, and I had the incredible opportunity to interview Manny Romero, the Head Athletic Trainer for the Kings at their Practice Facility. I was unbelievably excited for this opportunity and am proud to present my interview with Manny.
SCS: Tell us a little bit about yourself and how you got into Athletic Training.
MR: I started in 1996 with the LA Lakers as an intern right out of college. I went to college at Loyola Marymount and it just so happened that they practiced there at the time. And the Head Athletic Trainer at Loyola was actually a student of the Head Athletic Trainer with the Lakers, Gary Vitti. So Gary needed someone to help out with the summer session that they had and the Head Trainer at Loyola recommended me as a student. I interned a summer and asked if I could do a few games during the regular season and he said yes, so I showed up the first game, and I never left.
SCS: Gary Vitti is really well known, he is legendary.
MR: Yes, and he is still there. So I worked for him, at first on a volunteer basis and consistently came to every game. After a couple of years, he got me a paid internship and I got certified as an Athletic Trainer, and so I’ve been a Certified Athletic Trainer since 1998 through the National Athletic Trainers’ Association (NATA).
Soon after that, in 2001, the Sacramento Kings were looking for an Assistant Athletic Trainer. Pete Youngman (currently the Director of Sports Medicine) called Gary, and Gary recommended me, and so I came up here and interviewed and got the job. I was the Assistant Athletic Trainer until 2004, returned to the Lakers for a short time, and came back here in 2006, first as the Assistant Athletic Trainer, and then as the Head Athletic Trainer.
SCS: That is amazing when you think of the number of teams in the NBA. My hat is off to you.
MR: Right, there are only 30 teams. Thank you.
Manny Romero and Pete Youngman, the Kings Director of Sports Medicine
SCS: So how much do you see, communicate, and train with the athletes right now since summer league is over, and training camps don’t begin until October?
MR: Right now, we are in contact with them a lot. Some athletes are in town and they’ll come in here and work out with us. The ones that aren’t, we’ll call them and go out to where they live and make a site visit. We are in contact with their personal trainers if they have one, or any of the facilities that they go to. It’s person-by-person, but we know what the status of our team is all summer through correspondence.
And as we approach Labor Day is when you’ll start seeing a lot of guys come in, and in mid-September the majority of athletes are in town working out and getting ready for training camp that starts on October 1.
SCS: So you are ramping up then?
MR: Yes, it’s the calm before the storm right now. But post-Labor day, there will be an influx of players honing in on their basketball fitness and strength, and we’ll do assessments for injury prevention then.
SCS: So, from what I read, many of the injuries are caused by imbalances in the body and not being properly aligned. How are you assessing whether there are imbalances?
MR: We take a systematic approach. We use a variety of assessment tools. For example, we’ll take digital photographs and video of movements like a double-leg squat. That is a pretty good indicator of how the athlete is moving, and you can identify a few imbalances and dysfunctions just from that.
There are a variety of other movement patterns that we do, like inline lunge, a rotary stability test, and something as simple as a pushup to see upper body strength and core stability. So we have a variety of assessment tools that we use.
We use the functional movement screen developed by Gray Cook. We use body map procedures developed by the National Academy of Sports Medicine which involves the double-leg squat, and we do some gait analysis and some more dynamic movements like a drop-jump to see how their landing mechanics are, to see if there is any valgus load. Pete, myself and the strength coach will go over the assessments and screenings and determine what the major movement dysfunctions are of the athlete.
(Editor note: a knee that is perfectly aligned has its load-bearing axis on a line that runs down the middle of the leg. When the knee is not perfectly aligned known as malaligned, it is either varus (bow-legged) or valgus aligned (knock-kneed). There is a link between knee malalignment and knee osteoarthritis).
Sacramento Kings Forward Jason Thompson (34) is helped off the court by teammate Donte Green and Trainer Manny Romero, March 22, 2012. AP Photo/Steve Yeater
SCS: So are the injuries then caused by the muscular imbalances or movement patterns?
MR: The muscular imbalances cause the movement dysfunctions. Our bodies are masters of overcompensation. You can have imbalances but you can still perform at a certain level. That’s why you see athletes like Robert Griffin III (of the NFL) who is doing all of the explosive things at the combine, and then he goes on the football field and plants and turns and gets an ACL tear. It’s not a strength issue. This guy is strong. But you need the muscles to fire at the right time to protect you. And if they don’t it puts you at a risk for injury.
SCS: So how much are injuries caused by fatigue versus due to muscular imbalance?
MR: It could be because of fatigue, but if you are imbalanced the fatigue is more pronounced because it is stressing muscles and systems that shouldn’t be stressed. Fatigue does play a factor, but if you are more balanced and are moving more efficiently, then those systems will be less fatigued. That is why you need to move more efficiently. After the assessments, we hone in on the corrective exercise strategy for athletes even before they get on the court. It increases their durability and hopefully their performance, and decreases their risk of injury.
SCS: Which injury is most common in basketball? Is it the lower back, the ankle, or the knee?
MR: From the epidemiologic evidence I think the most common injury for a professional basketball player is the ankle injury. Since the ankle is the base of the kinetic chain, if you don’t rehab that properly, that can cause movement dysfunctions up the kinetic chain. A lot of time we’ll see back, knee and hip injuries as a result of a previous ankle injury.
SCS: Because the ankle injury threw the whole body out of alignment?
MR: Yes. There is some really good work done out of Johns Hopkins on pain and how it affects movement pattern. So if you have an ankle sprain, you will limp. Sometimes that altered movement pattern won’t go away without proper rehab and recalibration of the movement pattern. Although as slight as it maybe, that altered movement pattern from the ankle can predispose the knee to injury.
SCS: Since you’ve been doing this for so long, when you see an athlete just walking or running, can you see that they have an imbalance?
MR: Totally. There are certain things – like if a person walks with an in toe gait. Those are identifying imbalances in the body. We watch them and we observe them to hone in on exactly what is imbalanced, whether it’s a tissue extensibility problem (ie tight muscles), or a motor control issue, meaning that the muscles are not firing at the right time with the right amount of force.
SCS: So, if it’s a motor control issue, how do you correct that?
MR: Through exercise. If you know what the dysfunction is, the bridge to the correct alignment is the exercise program. So the three of us (Pete Youngman, Manny and the strength coach) prescribe the right exercises to move correctly. It’s a collaborative issue. ♦
Join us tomorrow for the conclusion to our interview with Manny Romero