The secret behind the Phoenix Suns’ elite training staff

The Suns’ training staff has earned a legendary reputation for keeping players healthy and productive, particularly vets like Hill, Shaq and Nash. Here’s how they do it.

PHOENIX — Channing Frye entered the penultimate game of last season in one of his patented shooting slumps.

The Suns’ big man had misfired on 30 of his previous 39 three-pointers and 52 of his 82 attempts overall entering the April 11 game versus Minnesota. So clearly something had changed for Frye when he shot like Dirk Nowitzki against the Timberwolves, canning a franchise-record-tying nine treys and drilling 12-of-18 shots overall in an overtime win.

Reporters over the years have heard all sorts of answers as to why an athlete caught fire on a given night, but on that evening Frye added one that may never have been uttered before.

Frye explained that his right butt cheek shut off, which then affected his thigh and his hamstring and threw off his balance and ultimately his shot. Once the Suns’ training staff fixed the first issue, Frye felt — and played — like a different player.

“They’re geniuses about this kind of stuff, so they’re like, ‘Oh yeah, this isn’t working, that’s why this is,’” Frye said. “Just so, so technical it’s ridiculous.”

The Suns’ training staff has earned a reputation as the league’s best thanks to an unorthodox style focused on preventing injuries through constant surveillance and integrating the latest medical research.

That has been the formula for doing the unthinkable — keeping Steve Nash healthy enough to play like an All-Star at 38, transforming the formerly brittle Grant Hill into a 39-year-old iron man (his recent knee injury notwithstanding) and eeking one last All-Star season out of Shaq, who played more games for Phoenix in 2008-09 than he had since 1999-00 and looked retired after he left – while keeping the rest of the squad as healthy as any team in the NBA.

“They’re by far the best training staff,” Frye said. “You can ask anybody who’s played here. It’s just the honest truth.”

So how do they do it?

Shaq dubbed the Suns’ training staff the YUMS, which stands for Young Unorthodox Medical Staff.

But to head athletic trainer Aaron Nelson, the Suns’ methods only seemed unorthodox to Shaq because he wasn’t used to them.

“To him it’s unorthodox, to us it’s regular science,” Nelson said. “It’s regular kinesiology, physiology, functional anatomy.”

In a nutshell, the Suns aim to ensure that a weakness in one area does not compromise other parts of the body. For example, if a player injures his right ankle he will start compensating by putting more stress on his healthy side, so the training staff treats the entire athlete and not just the injured part to ensure “there is no movement dysfunction,” as Nelson put it.

More specifically, the Suns chart an abundance of information on each player. This process starts with an overall assessment in the preseason that’s used as a baseline, and then rotation players are continually reassessed at least four times a week, if not daily.

These assessments can include the following:

• Utilizing a goniometer to evaluate players’ flexibility in eight different areas, including the big toe, the foot and ankle, the knee, the hips, internal and external rotations, and shoulder flexibility.
• Manual muscle testing to evaluate the strength of particular muscles. The trainers will also look for differences in the measurements of the legs, ankles and hips to see if they’ve deviated from game to game.
• Visual and movement assessments involving leg squats. The training staff will have players squat down a few times and watch for deviations. “Do the feet turn out, do the feet cave in, do the knees come in, do they come out, does the low back arch, does it round, all that kind of stuff, do they fall forward in their motion?” Nelson said.

From there Nelson and his staff can determine which muscles are tight or weak, which joints aren’t moving properly, and if there’s any neurological component that may be eliciting pain and causing dysfunction.

Then the trainers put together a program to counteract the issue, often involving manual therapy techniques that “either inhibit the muscle, stop it from being overactive or to lengthen the muscle and create that greater flexibility pattern,” Nelson said.

Each player is also given a corrective exercise program based off his frequent evaluations. Nelson said many of these plans are similar because they see many of the same patterns. In fact the head trainer said when the Suns fix issues corresponding with the TFL (Tensor Fascia Latae) overactive and glute medius underactive — this controls the femur and if it’s weak it wants to cave in, which can cause a variety of issues in the hip, back, knee and ankle — they eliminate 80 percent of their problems.

From there corrective exercises are the key for that particular player to get his body firing at optimum levels once again.

The perfect training staff for Nash

Aaron Nelson (left) has played a major role in keeping Nash playing at such a high level late in his career with minimal time missed to injury. Copyright 2008 NBAE (Photo by Barry Gossage/NBAE via Getty Images)

The past few seasons we’ve become accustomed to the “Nash days off,” whereby every so often the two-time MVP takes a shot to a body part that impacts his movement and requires a few days for him to return to All-Star form.

He’s constantly asked about his movement in postgame scrums, and it’s pretty obvious when he’s not moving quite right because those are the only times Nash becomes a sub-par shooter.

“He has spondylosis so any time he starts to have a little bit of even a minor, minor shift in the way he moves all kinds of stuff happens,” Nelson said. “It can go from his shoulder all the way down to his hamstring and his foot, so he is very, very adamant about getting in and doing everything he needs to do and doing it correctly.

“When he misses these games he’ll play to a certain point where a lot of athletes will just play until they get hurt or shut it down early. He kind of knows how far he can go before it’s like, ‘OK, I need a little bit of a break to readjust what we’re doing and get back down.’”

Nelson said when Nash misses a game it’s typically a movement issue.

“He gets a little pain from shearing forces, but then he doesn’t feel like he can stop the way he stops, when he’s shooting he might drift, so it’s changing just real small, small things with his body, and we’ve watched him every day for the last seven(-plus) years so we see that stuff,” Nelson said. “If you were just watching Nash play he either looks fatigued or he’s missing shots, but we can see some of those issues.”

When Nelson and his staff see this they put him through a series of exercises and positions he can usually handle that he cannot due to the injury, then scale back, and correct a few things before Two Time is good to go once again.

‘Our guys play’

The Suns’ medical staff is largely feted with praise thanks to their otherworldly efforts with the aging stars, but they have been just as good keeping the younger players healthy as well.

BrewHoop analyzed 11 seasons worth of injury data this summer (a time period that coincidentally covers Nelson’s entire reign as head athletic trainer) and determined that over that time period only the Spurs and Pistons lost fewer games than the Suns’ average of 50 games per year due to injury.

This analysis only looked at a team’s top nine players to figure out how many rotation games teams missed so that a Gani Lawal injury makes as little impact in these results as it did for the Suns last season.

In 2009-10 and 2010-11 the Suns amazingly lost just 20 such games to injury, tops in the league by an incredibly large margin over that two-year stretch. The Suns also missed only 13 rotation games during the magical 2004-05 season, according to this chart.

Basketball Prospectus’ Kevin Pelton measured health stats last year and found that only Oklahoma City lost less WARP than the Suns last year due to injury when Phoenix only missed out on 1.2 WARP despite an aging roster that featured Nash, Hill and the injury-prone vet Vince Carter.

Pelton also analyzed minutes lost to injury, which he calculated by multiplying minutes per game when healthy by games missed and found the Suns missed the second-fewest minutes in the league, with only four games missed by a player averaging 25-plus minutes.

This season has been more of the same, as the Suns have lost a mere nine games to injury (not counting rest games or illnesses), a total that was minuscule before Hill suffered a medial meniscus tear that has cost him the past five games.

Even with Hill currently in street clothes no other team has stayed close to this healthy, as even now the Suns have missed about half as many games to injury as the next healthiest squad (Utah) had missed at the All-Star break (17).

Considering the jam-packed schedule, the rash of injuries league-wide and the fact that Phoenix starts two of the oldest players in the league, that can’t be a coincidence. If you take Nash and Hill out of the equation, the Suns are a Jared Dudley thigh bruise that cost him one game away from perfect health. That’s it.

“Everybody says we might be a little bit biased, but it speaks for itself,” said head coach Alvin Gentry. “Our guys play.”

However, as good as these numbers look over the past decade, Suns fans still have nightmares over Joe Johnson’s orbital fracture in 2005 and Steve Nash’s bloody nose in 2007, injuries that cost the Suns dearly in the playoffs.

“We’ve had our bad breaks. In the playoffs we’ve just had a lot of bad things happen, and you can’t control those things,” Nelson said. “From our standpoint from when we do preventative stuff like strains and sprains and tendinitis and back spasms, things like that that are very common, I feel good if we can eliminate as much of those as we can, which over the years we have. I think our games lost due to injury are lower because we eliminate that aspect of it.

“Now if a guy tears his ACL or has to have microfracture or steps on someone’s foot and fractures his fifth metatarsal, we can’t control that, and you wish you could but it’s just impossible in any sport. You can do so much for prevention, but then it just stops.

“Then it’s a matter of keep your fingers crossed and hope nothing bad happens.”

The fountain of youth in Phoenix

Thanks to the success of Nash, Hill and Shaq, the Suns’ training staff is often viewed as a purveyor of a fountain of youth.

By now you understand that it’s just good old-fashioned kinesiology yet their results would impress even Ponce de Leon himself.

Michael Redd is the latest veteran seeking a late career rebirth after tearing his ACL twice in three years and being all but left for dead on the NBA scrap heap this offseason.

Redd did not know much about the Suns’ vaunted training stuff while spending his entire career in Milwaukee, but as he researched potential free agent destinations their success with players like Nash, Hill and Shaq “absolutely” made the Suns a team he wanted to play for.

“Just had some great confidence in their medical staff and the fact that they could help me out, recover, rebuild my career,” Redd said. “Obviously with Steve and with Grant being healthy at their ages, Shaq when he was here, it was a no-brainer for me to come here.”

Redd said the training staff pinpointed issues he needed to be corrected in his hips and legs, adding that the constant stream of preventative work is one of the biggest differences he noticed in Phoenix. The sharpshooter saw an immediate change in his body even in the first week after his arrival thanks to some of those corrective exercises.

“They’ve been phenomenal,” he said. “They’ve told me things about my body I haven’t heard my whole career. They’re a special group here.”

The proof is in the pudding as always, and although Redd has not exactly reverted back to All-Star form he’s provided a spark off the bench at times, such as his 25-point outburst on March 18 against Houston and the 35 points he has scored in the past two games for a Phoenix bench that desperately needed that kind of punch.

Not bad for a player many thought would never contribute to an NBA team again.

The Suns’ Moneyball

The Suns’ training staff aims to stay ahead of the curve, which is why this season Phoenix became one of four NBA teams to introduce a Cryosauna (Suns.com likens its look to “a refrigerator for people”) into its players’ recovery routine at a cost of around $50,000, The Arizona Republic reported.

According to Hill, it utilizes the same philosophy as a cold tub only at nearly 300 degrees below zero.

“It’s colder but it’s not wet, it’s dry,” he said. “You don’t stay cold like you would in water. It’s different. It’s definitely cutting edge, and it certainly says a lot that they would make that kind of investment. It’s certainly a lot more expensive than water is.”

Added Marcin Gortat, “It’s actually like a winter in Poland. Every time when you go in the store to buy something that’s how it is every month in Poland.”

Meanwhile, across the nation in Yankee Stadium, baseball star Alex Rodriguez has become a believer in these methods.

This offseason he began working with Dr. Mike Clark, the CEO of the National Academy of Sports Medicine who has worked with the Suns and Nelson for years as a physical therapist. According to the New York Post, A-Rod spoke to Hill about these techniques and the baseball star became “an almost instant convert.”

Nobody following the success of Phoenix’s veterans, therefore, should be shocked if A-Rod turns in a healthy monster year.

Twelve years ago when Nelson was promoted to the position of head athletic trainer in Phoenix, he collaborated with Clark to “approach injury prevention and rehabilitation differently than what’s most common.”

“This is the approach that we came up with,” he said.

The Suns’ general manager at the time, Bryan Colangelo, gave him the green light, and every year they tweak portions of the program depending on what the latest research finds to be effective, be it techniques, exercises or whatever else.

“So we use all that data,” Nelson said. “It constantly changes. It’s not like, ‘Hey, this is it, we’re set in our ways.’ It changes, and I think that’s one of the reasons it’s successful because we’re able to adapt and find better ways to do what we’re doing.”

With the help of Clark, Nelson is overseeing his own version of Moneyball by using his research and these techniques to keep the Suns healthy on a far more regular basis than an average NBA team.

This has created a competitive advantage for the Suns as they have discovered a more efficient way to keep players off the inactive list and playing to their peak potential regardless of age, just as on-base percentage and working deep in the count gave an edge to Billy Beane’s A’s.

However, unlike in baseball’s Moneyball, the rest of the NBA has yet to catch on.