SBJ Tech: The NBPA’s chief doc on new workload study

Last week, a powerhouse contingent -- the NBA, NBPA, the Next Gen Basketball Players Union, GE HealthCare and MedStar Health -- announced a pilot study to quantify player workload during a season. The findings for this could not only change the way teams handle their player health but also drastically shift the cost of injuries that franchises incur.

The Journal of Science and Medicine in Sport published findings in March that the cost of player injuries extends well beyond salaries and often underestimates the costs of health care. Another study in the JSAMS report estimates the economic loss of 35 ACL injuries in the NBA between 2000-2015 at $99 million. Salaries and costs have only gone up since then. The league can’t afford not to get ahead of this.

Players on four G League teams participated in the data collection from training camp through the end of the season. The long-range tracking of player health included wearables along with imaging technology (such as MRIs and ultrasounds) to produce the most comprehensive study on the topic to date in basketball.

I recently connected with NBPA Chief Medical Officer Dr. Asheesh Bedi to ask about the large-scale data effort and determining what tech (like Springbok Analytics’ 3D muscle visualization) is best for this process. He explained why there’s still such a struggle to understand comprehensive workload and what it means to turn real-time findings into future benefits for NBA players.

On piecing together a massive data-collection effort: “The concept of workload and load management has been one of interest for player health and performance across a variety of different sports for athletes of all levels. And as you dig into that area, there's the realization that workload reflects many different aspects and facets of physiology, and it incorporates components of so-called internal workload, components of external workload and an understanding that requires a thoughtful consideration of various, different streams of data that contribute to the overall workload of an athlete.

“And what has been different is in the past, trying to assess and answer those questions has largely been retrospective work -- working backward and seeing what information we might have to provide insights. But what we've also learned is a lot of that retrospective work is not comprehensive. And so prospective work raises the bar, because it allows us to identify some specific study questions and hypotheses, and then to design the study and collect the data in a more comprehensive and rigorous way to really answer that question.”

On determining the tech needed to measure the data: “In order for this type of study to be meaningful, the tools that you use to assess information need to be validated, and they need to be reliable. And that's across the board -- that's for imaging, that's for biomechanics testing, that's for kinematic analysis and that is for wearables and sensors. As you can imagine, that was not undertaken lightly. And what was remarkable about this study and much credit to my partners across the aisle with the league -- this was a coming together and designed decision making of let's make sure that we identify experts and key opinion leaders in each of these different domains, and actually design committees and subcommittees to provide those recommendations of what the best tools and approaches would be in such a study, to at least collect the best data set possible that was also appropriate and could be embraced by the players participating in the study. The success of such studies is fundamentally incumbent on the players’ desire, interest and motivation to participate. And so this required a strong partnership for them to understand the value of this information in improving their health and care.”

On the use of Springbok Analytics: “In a study like this, our goal was to be as comprehensive and thorough as possible, and imaging is a critical component of that. In this study, we wanted to have the best characterization of the soft tissue and patellar tendon specifically looking at the question of patellar tendinopathy. But we also wanted to understand what the implications may or may not be for muscle volume and atrophy and asymmetry. Springbok is one such tool that has offered significant clinical insights into muscle volume and asymmetry, and it naturally lent itself as one potential tool to use for such an assessment, among others.”

When the UFL picked Kitman Labs’ Intelligence Platform (known as iP) as its electronic medical record (EMR) provider, the league addressed a clear need. Still in its debut season following the merger of the XFL and the USFL, the UFL can now check the boxes on both sides of the player health data equation -- supplying the league with structure for governance and uniformity while giving teams the flexibility to customize their experience in the system.

A secondary benefit to this deal is also compelling. The UFL can now experience an easier incorporation of health care data during its yearly injection of new players joining the league from college. Kitman Labs has worked with the collegiate environment to develop a passport-like vehicle for their medical data. For a league like the UFL, which has framed itself as a minor league-like setup for the NFL, it can now benefit from Kitman Labs’ approximately 60 connections in college football.

Called Player Movement (a feature available to all sports in Kitman Labs’ collegiate offering), players can approve the sharing of their accumulated collegiate medical records from their college account to their UFL account. Stephen Smith, former injury-rehabilitation-coach-turned-Kitman Labs CEO, said oftentimes even when the player data may be a full tech flywheel, the intake of combine or draft information can often come in a comprehensive pen-and-paper model that doesn’t always translate to the data ecosystem. Player Movement, which is part of Kitman Labs’ Performance Medicine Solution of iP, improves the care a player can receive.

“When you think of the decision-making criteria that a sports medicine practitioner or physicians will go through every day, they’re making decisions about how they treat the athletes or making decisions about how they return them to play,” Smith told SBJ. “And if they’re doing that when they don’t know [the answers to] how does this person normally recover, what types of treatments do people normally do on them? How effective are they?

“They don’t know what the previous injury history is, and you have to go and search and hunt for that. That means it just doesn’t happen.”

This is a longtime capability for Kitman Labs through its experience in professional soccer and its international transfer market. Health care systems (especially from country to country) can vary in their requirements, and it’s a problem that Kitman Labs took head-on in the development in its global footprint. Player Movement has become more useful in the American college space with NIL profitability for players and the transfer portal.

Kitman Labs developed its footing in the college space roughly five years ago. Smith said partnerships like its work with Georgia -- which has won two CFP national championships since Kirby Smart took over the program in 2016 -- as early successes. That collaboration paired leadership dead set on the ultimate success with Kitman Labs’ outside perspective.

Smith noted that there’s much more pressure on all leagues to provide these supportive health care systems for their players’ data. Player Movement is an attempt to streamline that process and break down the potential silos in the college-to-pro shift.

“All of the best leagues in the world now are investing enormous amounts of money in their health and safety,” Smith said. “They understand that these athletes are their assets and their gains -- like the successes of their businesses -- are built on their backs.

“And if you don't have the relevant information at hand for the stakeholders around them, then that’s hugely limiting and we’re putting player health and safety at risk -- which nobody wants to do anymore.”

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