April 18, 2023 • 52 mins
As the game of baseball continues to evolve, so do the injury patterns we see. To stay ahead of the trends, it’s important to build a high performance team in professional sports.
In today’s podcast, I talk to Dr. Chris Camp about the high performance team of the Minnesota Twins, mitigating injury risk, and future trends in baseball injuries.
Full show notes: https://mikereinold.com/managing-injury-risk-and-high-performance-in-baseball-with-chris-camp
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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
(00:00):
On this episode of the sportphysical therapy podcast, I'm
joined by Dr.
Chris camp.
Dr.
Camp is an orthopedic surgeon atthe Mayo clinic in Rochester,
Minnesota, and is the medicaldirector and director of high
performance for the Minnesotatwins.
Dr.
Camp's a prolific researcher inthe field of baseball injuries
with an enormous amount ofpublications.
And this episode, we're going totalk about building a high
(00:20):
performance team andprofessional baseball.
And how we can predict andmitigate injury risk, and then
some of the trends in injuriesthat he's seeing in baseball.
Mike (00:40):
Hey Dr.
Kemp.
Thanks so much for joining us onthe podcast today.
Really appreciate you, uh,taking some time outta your, uh,
I'm sure hectic schedule isyou're getting ready for the
baseball season.
But thanks so much for joiningus.
Chris (00:50):
You got it.
Mike.
Thanks so much for having me.
It's a, it's an honor and apleasure to be here.
Mike (00:54):
That's awesome.
Um, I, I recently had an episodewith Dr.
Brandon Erickson, and I had avery similar introduction with
him where I said, gosh, wecould, we, I don't know how you
do this much research inbaseball injuries, and we could
talk about about a thousandthings.
But we are super thankful forall you're doing because you've
really helped us understandbaseball injuries so much more
(01:16):
with just your, your mounds andmounds of research that you guys
published.
So thank you for all that youdo.
Chris (01:21):
Oh, you got it.
I l love to do it.
And obviously, you know, Brandonand I are good friends.
We work together on a lot ofthings too, and he and I share a
similar passion.
You know, there's a, we, we'vegot a lot to figure out.
Um, and I, we feel like we'rejust getting started.
We're just sort of hitting thetip of the iceberg.
So very excited about what we'vedone so far, and even more
excited about what lies in thefuture.
Mike (01:40):
Do you ever look at the research and think to yourself
that, wow, like we, we feel likewe're advancing ourselves, but
the more we dig into it, themore we realize that injury
rates just keep going up and upand up and we're, we're
ultimately failing, right?
Chris (01:51):
No question.
And that, that's one of thefunny things about research too,
is I always tell folks if you,if you do a really good job
designing a, a study and youconduct that study, it gives you
an answer to a question.
And then it gives you three morequestions.
And so I, I feel like we arelearning more, but we're also
learning more.
We're also learning how much wedon't know.
The more, the more of this we dotoo.
(02:12):
So there, there's a lot of, uh,job security in it for sure.
Mike (02:15):
Yeah.
You know, and I, I think yousaid that really well too.
If you even just look at y youknow yourself and others, but
you know the history of some ofthe data that we're getting from
Major League baseball injuries,we're seeing it progress from
like broad strokes.
Like, you know, you know,demographic, uh, epidemiology
type things based on, you know,simple demographics and stuff
like that, um, to now gettingmore specifics.
(02:36):
So I, I think you're right.
I think over time we are gettingmore and more out of all this
data that hopefully continues tomake progress, but we'll see.
Right.
Chris (02:45):
Yeah, absolutely.
And I think you always have tostart with the.
So you, you always wanna askwhat's going on out there?
What, what are the injuries?
What's really happening?
What is impacting players?
And, and that's sort of whatthe, the first phase or wave of
the MLB research has done forus.
It's kind of told, told uswhat's happening, uh, now the
next question we have to startasking is why.
(03:08):
And, and then we have to ask howdo we fix it?
So tho those are the harderquestions that are, that are
coming up for.
Mike (03:15):
Well, you, you, uh, what I'm excited about is that people
like yourself are behind these,uh, endeavors in the future
because, I mean, we, we've seenthis in the past when, when all
you see is injured baseballplayers.
Then sometimes it skews yourperspective a little bit.
And what I like about yourselfnow you're, you know, you're
currently the director of highperformance, the medical
(03:35):
director of for the twins,right?
So you are not just seeinginjured players, you're seeing
healthy players, and you'reseeing players that not only
wanna prevent injury, but wantto enhance performance.
Right?
So, you know that perspective tome, I.
Gives you a, a, a better, abetter approach to your
projects.
Right.
And I think we're starting tosee that when, when you start
(03:55):
publishing things that, youknow, I can see that at least
where, where you're coming from.
Chris (04:00):
Yeah, that, that's a great thought, Mike and I, and I
think it's true.
I think for all of theseproblems, the the solutions are
gonna lie in.
Bringing together people whohave broad perspectives.
Each one of us sort of has ourown biases and ways of looking
at things and our own pastexperience that shapes and mold
us.
And because of that, no oneperson has all of the answers.
(04:21):
And, and so I think to figureout these relatively complex
things, we've got to bringtogether people from.
Diverse backgrounds,experiences, diverse ways of
looking at things because we, wesort of need to look at these
problems from a 360 degree viewall, all the way around, and
that's the only way we're reallygonna be able to make any
serious headway on
Mike (04:40):
I like that and, and it really sounds like that is what
you put behind your current.
Role with the twins.
Um, and you know, I, I, I, Ilike your title.
I thought that was nice too,because most orthopedic surgeons
are either team physicians ormaybe they're, uh, you know,
head surgeon or medicaldirector, but you added director
of high performance to that.
And I think that speaks volumesabout probably what yourself and
(05:04):
the organization are thinkingabout our department now.
It's not just health, but alsoperformance.
Um, tell us a little bit aboutthat role that you play with
the.
Chris (05:12):
Yeah, absolutely.
So, so I think most people aresort of familiar with the team
physician role, um, coveringgames, taking care of injuries
that they come up, and also sortof familiar with the medical
director role.
So trying to make medicaldecisions about injuries and
illnesses across theorganization.
But the.
The high performance role I, Ithink, is a little bit unique,
uh, for us ev Most teams nowhave some sort of.
(05:36):
Director of Sports Science or,you know, some, something along
those lines.
But with this, what we've puttogether in, uh, this role of
director of high performance isreally something that we have
been thinking about for severalyears.
Uh, myself and some of the folksin the front office, Derek
Fowley, FA Levine, about how wecould really shape the, the
entire department.
And for us, what we define asthe, the High Performance Group
(05:59):
is not just folks in.
Um, not, not just thephysicians, but also our
athletic trainers, our physicaltherapists, strength and
conditioning.
Our dieticians and nutritionistsmassage the.
Uh, sleep hygiene folks, mentalskills, sports psychology,
chiropractors, sort of everybodyin in that group.
And, and it's a, it's a biggroup.
(06:19):
It's a diverse group.
We all have a different way oflooking at things, but
ultimately we need to, to try tounify our, our vision, and
that's kind of how we see that.
In.
In addition to that, we're alsostarting to bring in more of
the, the sports size people, theresearch and analytics, uh, into
that same space as well.
And I think for any of us to besuccessful in this area, we have
(06:40):
to recognize that no one personhas all of the answers.
Um, no matter how good you are,how much you've done, or what
your experience is, you, you'restill very limited.
And me as an orthopedic surgeon,I, I could spend the rest of my
life, you know, studying and Istill wouldn't be nearly as good
as our strength and conditioningcoaches that have already been
doing it for so many years.
(07:02):
Right.
And so I can't pretend to havedomain expertise in that area.
Um, even if I think I reallylike it and I pay a lot of
attention to it, and I, and Istudy it extensively, same
thing.
You know, I can't.
Even begin to imagine havingdomain expertise in the, in the
world of sports psychology.
I, I know a little bit about it.
I'm interested in it.
I think it's criticallyimportant, but I'm not an expert
(07:23):
in it.
And so really in that role, I, Isort of view myself as kind of a
coordinator of experts and, andthat's really how we've tried to
shape it, um, with, with thetwins organization.
So it's, it's not one personwho's, uh, completely in charge.
We're a team of equals,everybody's sort of on the same
page, the same level.
Uh, there's sort of minimal.
Hierarchy to it.
(07:44):
Everybody has a seat at thetable.
Um, and we care about whateverybody thinks.
And, and I think that taking anapproach like that is definitely
difficult at times.
Um, it's a little bitcounterculture.
To a lot of organizations andbaseball in general.
So it, it's definitelydifferent, but I think that it
is, it, it's worth doing it.
It certainly comes with some,some nuanced, uh, headaches and,
(08:08):
and, uh, problems, but I thinkthat those are all worth having
and worth sorting throughbecause if we're ever, if we're
ever gonna get it, we're gonnahave to get it together and
we're gonna have to gocollectively as a team.
Mike (08:18):
That's awesome and, and totally refreshing to hear, um,
what, what I like more thananything else was just listening
to that from your perspective.
To me is this is what makes youa great team physician.
Right?
And, and not every doctor is thebest.
And just like, not every, anyprofession is, is great, but the
understanding of the role of ateam physician, it's not a
(08:40):
dictatorship.
It's not an ego trip thing.
It's, it's, it is about beingthere for the players and being
there for leadership.
Um, I, I just think the way yousaid that was, So excellent
that, um, I really hope a lot ofpeople get to, uh, you know,
experience working with a, aphysician like yourself in this
environment because that'sexactly what we need, right?
We are, we're evolving as agame.
(09:01):
We're evolving as all theseinterdisciplinary people like
work together and, and it'soppressive thing that you guys
are building with the twins, weput all those people together.
It wasn't that long ago that aa, a big.
Medical staff was a head trainerand assistant trainer and one
strength coach.
And that's it.
That was, and I'm talking aboutlike single digit years ago,
right?
Like that wasn't, that wasn'tdecades ago.
(09:23):
Right.
And look at how much you guyshave built.
So when you started with thetwins, where, what was, what did
the department look like andwhat does it look like now?
I know you kind of alluded tolike all those different people,
but how have you seen that grow?
And the reason why I ask that isbecause I think a lot of my
listeners are very eager to getinto pro sports, and I like how
there's so many differentavenues now to get there.
(09:45):
It's not just, oh, you have tobe an athletic trainer.
There's, there's 10 differentprofessions that you just listed
right there that can get inthere.
But tell us a little bit aboutthe evolution of the twins,
because I think we're gonnastart seeing that more and more
with other.
Chris (09:58):
Mm-hmm.
Yeah.
So, and that's a great thoughtand, and I think our evolution
has probably mirrored that of alot of other organizations in
that, you know, let's say fiveyears ago we had components of
strength and conditioning and.
Athletic training, physicaltherapy, nutrition, a little bit
of sports, psych and mentalwellness.
We, we sort of had all of thosecomponents, um, some of them
(10:21):
more robust than others.
And so I, I think that ourbiggest evolution has, has not
necessarily been adding newdomains to the team, but
actually expanding.
Each of those domains andcollectively bringing them
together.
That's it.
So, so we now have, we'vealways, we, you know, we've had
strength and conditioning for awhile.
(10:42):
We now have more strength andconditioning coaches.
Mike (10:44):
Right.
Chris (10:45):
We've also sort of changed the structure and the
hierarchy with within the, thestrength and conditioning area
and within the physical therapyspace and, um, and, and in all
of our spaces, um, to create, tocreate a system where there's a
lot more coordination withinthat domain and across all of
the other domains and incollaboration.
(11:05):
So I think our biggest evolutionhas not just been growing in
numbers and size.
But more so growing incollaboration and making sure
that everybody understands whateverybody else is doing, what
they're capable of, what theirskill sets are, where their
shortcomings are, you know, howwe can help them make up for
those and, and those sort ofthings that that's been the
biggest focus of our evolutionover the last several years.
Mike (11:28):
That's fantastic.
And, and I, I, I like thatprogression.
That's something that, um, I'vebeen trying to build with the
White Sox myself.
Too.
I mean, we're al Centralcompetitors here.
We shouldn't be giving eachother secrets maybe.
But, uh, it's, uh, the, um, uh,you know, the concept of a
leadership tree, and I thinkthat's exactly what you just,
you know, provided a frameworkfor right there.
(11:49):
It's the same thing, but is thatwe have a bunch of peers.
That are all within leadership,right?
It's not a dictatorship.
It's not like one person typething.
It's about how do we put all ourheads together and how do we
collaborate and how do we leavea room where we're planning on
something?
Anything a a, a strength andconditioning program, a a prep
work.
Program, a rehab program for oneplayer, how do we leave that
(12:11):
room in unison where everybody'shad a chance to talk about it?
Everybody's had a chance tovoice their perspective, which,
which often changes the overallprogram.
Um, it's, it's really, reallyawesome to kind of hear that and
see that.
And I have a lot of friends thathave come through the twins
organization that speak reallyhighly of it.
So, um, you know, again, kudosto you for, for seeing this and
for, you know, emulating thisfor some of the peers that
(12:32):
you've worked with around theleague.
Um, it, it just sounds like youguys are doing a great.
Chris (12:37):
Good.
Well, we're enjoying it.
And you know, we're, we'reseeing some, um, some dividends
pay off too, so it's been great.
We're gonna keep at it.
It's obviously, it's a lot ofhard work.
It's anytime you're changing,you know, the culture of, of
baseball.
With an organization can, it canbe difficult.
But, uh, it has been very good.
We've made some tremendousprogress, so we're, we're
excited about where we're at nowand where we're headed in the
future.
Mike (12:57):
That's awesome.
That's awesome.
And it, and it helps that youhave a great front office and
you have a great manager.
Right?
A modern think manager.
I mean, it's, um, it's, it'sit's support, right?
That's, that's what you need inyour role is support from
everybody, from field staff,from front office, from data
analytics.
It's, it's, that's what, what'sthe glue that keeps everything
together?
Is that everybody's on the samepage.
Chris (13:19):
A hundred percent.
And, and that's a lot of whatwe're trying to do is, you know,
we're breaking down silos notonly within the performance
space, but also within the wholeorganization.
So we we're very blessed in ourorganization in that we do, we
have a front office that sort ofbelieves in this model.
We have a manager that believesin this model, and I think part
of our job, in the performancespace is that we have to reflect
(13:40):
the culture of the other areasin the clubhouse.
So a player needs to be able toflow freely from the dugout to
the clubhouse or locker room,into the weight room, into the
athletic training room.
With that same sort of feeling,that same sort of culture, that
same sort of vibe, that sameenergy in all of those spaces.
(14:02):
You don't want'em to all of asudden come into the athletic
training room and think, oh no,this, this is where I have.
Do X, Y, Z or I gotta change mybehavior in this space, or I
gotta act a certain way in thisspaces.
Now we, we want the whole thingto sort of have the same, same
feel and vibe.
And I think that's reallycritical for our players in
order to be comfortable tounderstand what we're doing to
buy into the programming that wehave.
(14:23):
And you can't do that without asupportive coaching staff, front
office staff and players, uh, tobe honest.
And we're, we're blessed to haveall of those.
Mike (14:31):
Sure.
And, and great leadership fromyourself too.
I mean, to give yourself some,some credit here, it's, it's
putting that glue together aswell.
So, um, um, great stuff.
Um, one of the biggest rolesthat these departments play,
right, is in risk.
Mitigation, right.
Injury prevention, injuryprediction.
Even.
Um, you know, some people referto this, you know, 20 years ago,
(14:51):
you know, uh, you know, we, wewere talking about this as the
money ball for, for medical,right?
Where we started taking data andtrying to, to, you know, predict
and prevent injuries.
Um, what, what do you think therole of your department is for
injury prediction in riskmanagement?
Not, not just prevention, butprediction.
How have you guys workedtowards.
Chris (15:10):
Yeah, that, that's a, that's a great question.
And honestly, you know, it'spart of the, part of the holy
grail.
It's, it's complex, it'sdifficult, but in reality, one
of the things I've always talkedabout is if you look at our
research and analytics team, Ithink this is the same.
This is true of everyorganization.
They do a phenomenal job ofpredicting on field performance
of players.
(15:31):
They have a pretty good idea.
It's never perfect, but they,with some reasonable accuracy,
can predict the number of wins.
A team will have the predictedwar of this player, that player
wins losses, starts batting atthose sort of things.
They, and they do a remarkablygood job.
It's never perfect, but it'spretty good.
And so one of the questions I'vebeen asking myself is, why can't
(15:51):
we do the same thing?
Health and injuries.
You know, why, why can't we?
And we haven't been that greatat it in the past, but I think
we can be.
I, I, I really do.
I I truly confidently, uh,believe that that is the case
and we're gonna get there.
Um, but it's not easy.
And, and I think in, in my mind,there's, there's really
(16:12):
probably.
Five major steps that we have totake in order to start talking
about risk, uh, our injury, riskprediction and mitigation.
And I think number one, we haveto first define the problem.
Uh, and we've been spending alot of years doing that, sort of
identifying what are the biginjuries?
What are we actually missing outon?
And then second, I think we haveto think about once, once we
(16:34):
identify the.
We have to recognize which ofthose problems we can actually
influence.
You know, there are certaininjuries that we probably will
never control.
Um, liner comebacker to thepitcher, hits'em in the auto
fractures.
You, you can't predict that.
You can't control that.
Don't waste your time, you know,on that.
So, so figure out which, whichof the injuries can you actually
(16:55):
influence and.
Once you do that, the, the thirdstep is sort of identifying all
of the factors that contributeto that injury, which is
difficult, and that, that sortof takes that approach across
all of the different domains.
Um, and I, and I think that'svery complex and very quickly
you start running into a lot ofinformation and a lot of data
(17:16):
because, you know, some of thethings that contribute are prob
their, their movement patterns,their strength, their diet,
their sleep, their workload.
um, their overall performance,their running speed.
I mean, all of these sort ofthings contribute.
So you sort of have to figureout all the factors that
contribute.
And then once you do that,fourth, you have to figure out
which one of those you canintervene on and modify.
(17:39):
And I think that has to reallybe individualized to the player.
Um, because some players you canmodify certain things or
intervene on certain things.
Other players, they, you may notbe able to modify that.
Or if you do, Lowers theircompetitive balance and you
know, that's not somethingthey're willing to do.
So you sort of have to identifythose factors and actually
intervene.
And then the fifth and finalthing I think that we have to do
(18:01):
is that we have to continue tomeasure our progress and then
adjust.
So, you know, you, you gothrough all of these steps and
you say, okay, did we actuallymake a difference here with
this, with the injury?
We identified the steps theycontributed to at the
interventions we interact, we.
Now, did it work?
What, what's the difference?
And if so, great.
(18:23):
Now how can we incorporate thisinto the normal routine?
If not, let's go back to thedrawing board, try it again.
And, and it's sort of that fivestep iterative process that you
just have to keep going through,over and over and over again,
um, to infinity really, to, totry to figure it out.
Mike (18:38):
And, and just when you think you've, you've figured
something out.
You, the unexplainable happens.
The, uh, extra inning game, the,the.
West Coast Road trip, althoughthat's not as exciting for the
Al Central as it was for the ALEast.
But there's, you know, there, Idon't, I, I try to tell people
this all the time, but somepeople don't realize this.
You know, we play, I, I, what isit, 162 games in 180 days.
(18:59):
And I try to explain to peoplelike, you wake up, you go to
work, you come home, you know,you turn on the twins game.
great.
You know?
Then next day, you know, youwake up, you go to work, you
come home, you turn on the twinsgames, like, wait a minute, now
they're, now they're in Tampa.
How'd they get to Tampa?
Like, like, like how, how'd thathappen?
Be like, people don't, peopledon't appreciate the stresses
that go into the body here, andwhen you have to play every.
(19:21):
Day, like every single day.
It's, it's super challengingbecause the players, if, if
they're not performing well,they, they wanna practice more.
They wanna take extra reps inthe cage, they want to throw
more in the pen.
And that's almost like the, thatfine balance between workload
and capacity that they'redealing with at all times over
the year.
That like we can do as best aswe can.
(19:43):
And then you just get thrownsuch a curve ball.
You can't control everything.
It's frustra.
Chris (19:49):
It, it's extremely frustrating and we, we've all
seen that too.
You know, you, you get theplayer that you know needs some,
some rest and you show you tryto work, give him a day off.
Then you go in the weight roomand you find I'm just crushing
the weights for three hours.
Like, it, it would've been lesswork had you played today.
You know, this was notdifficult.
So, yeah, it, it is tough and,and also too, The other thing
that's hard is that if you lookacross injuries, uh, as the
(20:13):
entire professional baseballworld, you know, that's about
7,000 or so players.
So you have a pretty largedenominator to look at injury
trends and things.
If you look at it within asingle team or just within a
major league, an active majorleague roster with 26 or so
players, it's a really smallsample size.
And so having that small samplesize makes it difficult to know
(20:37):
when I see injuries, you know,ticking up.
Is this a true trend?
or is this just randomrandomness?
Because we have such a smalldenominator, it, it does make
the, the comparisons are prettyfragile, so you have to be
really careful not to overread,um, into negative trends or give
(20:58):
yourself too much credit ifthings go well.
You know, because
Mike (21:02):
that's, that's great.
Chris (21:03):
every year, I mean, sometimes you're just a couple
of injuries, one to twoinjuries.
From having a terrible injuryridden season versus the best
season you've had in years.
So it's such a fine balance andwe have to be very objective
about how much of that weactually control to the positive
and the negative in, in bothdirections, which I think also
makes this more complicated andcomplex.
Mike (21:25):
That.
Absolutely.
So in your position, in, in yourresearch, you've done a lot
about, um, tracking trends.
In injuries in baseball, and Icould say over my almost 25 year
career right now, the, theinjuries that I was seeing in
the first half of my career aredifferent than the injuries I'm
seeing now in my second half ofmy career.
(21:47):
Uh, it's almost like the gamesevolved.
The the players have evolved,their practice patterns have
evolved and their injuries are,uh, evolving with.
And you know, it's, it's funnywhen, when you see that, because
you still see some outdatedthings based on some of the, the
information we had 20 years ago.
Uh, but I'm curious from yourperspective, somebody that's not
(22:08):
only on the inside every daywith the team, which is an
amazing resource for your ownknowledge, um, that I'm sure you
appreciate, but like, don't evertake for granted that you.
Best Petri dish in the world isthose 300 baseball players that
you take care of.
Right.
But, um, uh, in your perspectivebetween that and the data
collection that you're seeingfrom Major League Baseball, what
(22:28):
are some of the, the, the trendsthat you're seeing, some of the
things that are evolving, whatare we, what do you think we
might start seeing more of?
I, I'd love to just, you know,you know, and I hate to give you
such a crazy vague, open-endedquestion, but let's, let's start
chatting
Chris (22:42):
Yeah, absolutely.
So, uh, that's a great questionand I think there's a lot of
different ways we could takethis.
And I mean, one of the mostinteresting and obviously the
most sort of publicized, um,injury trends that we see is
that of Tommy John injuries or,you know, media honor,
collateral ligament injuries.
And for years and years we'vejust talked about, oh, rates are
going up, going up, going up,going up.
(23:04):
But I think we're at a spot now.
It's a little more complicatedthan that.
And, and actually if we lookwithin the last few years, what
we've seen is we've actuallyseen a slightly lower frequency
in Major League players withTommy John injury, which is
great.
And there's a tendency to stopand say, Hey, we're doing a good
job.
Let's pat ourselves on the back.
We've
Mike (23:24):
Right,
Chris (23:24):
thing out.
Mike (23:25):
right.
Chris (23:25):
there's even, there's been a few And, and there's even
been a few articles that havebeen printed to that effect.
But then if we really look atthe data, what we see is,
Although Major League, Tommy,John injuries are going down the
minor league, injury rates aregoing sky high.
Mike (23:42):
Enormously Enor, and that's one of my favorite graphs
that you show.
That, that I've, I've used that.
Stan, let me borrow one of yourgraphs, I'm sure.
But, um, like omg, we talk aboutthis Tommy John injury.
Epidemic, right.
That, that, that we have inmajor league baseball and it's
nothing compared to the lowerlevels, minor league baseball.
And heck, I, I, from myperspective of what I see in my
(24:03):
practice college in high school,it's the same thing.
They're going crazy.
So it's funny you said that,that, you know, we, we pat
ourself on the back for a hotsecond there about Major League,
but it's just that they'rehappening earlier.
Chris (24:13):
Yes, exactly.
And that, and that's what'shappened.
So they're getting shifted toyounger ages, whether that's
minor league college, and noweven starting to be in the high
school.
And what I worry about with thatis that as those.
The rates of primary Tommy Johnsurgeries and first time Tommy
John injuries starts to shiftdown to the younger players.
If in response to that on theback end with the major league
(24:37):
players, we're gonna start tosee an uptick in the number of
secondary Tommy John injuries orrevision Tommy John
Mike (24:43):
Sure.
Chris (24:44):
So I think we're already starting to see that now.
Where?
Where, yeah, the number ofprimary surgeries is.
Probably down in the majorleagues, but the number of
revisions are ticking up andthat's because now guys are not
having their first Tommy John asa major leaguer.
They're having it as a minorleaguer or a college or even a
high school athlete.
Mike (25:03):
Yeah.
Wow.
Chris (25:04):
it's becoming revision time by the time they get to the
leagues.
So I, I think that is somethingthat we're probably going to see
and then that opens up a wholenother can of worms is how do
we, how do we handle theserevision cases, which we know
are a little bit tougher andharder to rehab and less
predictable?
And so I think this problem'sgonna get harder before it gets
easier.
Mike (25:23):
And I remember too, we used to say that, uh, Tommy John
lasts like 10 years, right?
And we were doing them in 32year olds, right?
That that was, that was 20 yearsago.
And we'd say like, nah, thiswill, this will last longer than
your career.
Then we started saying, okay,maybe they last like seven or
eight years, and now we're like,okay, maybe they last like.
Five years Right.
So it's, it's like they're eventrending that way.
But you know what, I think we'reat a really great spot though
(25:45):
for this to occur because wehave some options now, right?
We have the new internal bracewith the repair, um, even some
hybrid techniques and know youand I have, we've shared
patients that have had arevision with, with the internal
brace that are still doingoutstanding several years later.
So, um, where do you see thatevolving?
Where do you see that cominginto?
Chris (26:06):
Yeah.
And, and I think that this is anarea that is ripe, uh, for, for
some advancement.
You know, if you, if you thinkabout the most common surgical
techniques for Tommy John'ssurgery are the, uh, figure of
eight of the modified jobtechnique and the docking
technique.
And both of those were describedin the early two thousands.
2001, 2002.
(26:27):
So almost 20 years.
And not a ton has changed, andthere's hardly anything in
orthopedic surgery that we'redoing the same now that we were
doing 20 years ago.
Mike (26:37):
That's a good point.
Chris (26:38):
but this, that has been the case for that surgery.
And that's, and it's not from alack of trying.
People have tried, there's allsorts of different techniques
that have been described outthere that just didn't quite pan
out.
Nobody's really been able tofigure, figure out what the next
level is.
And then in recent years, we'veintroduced the concept of the
internal brace, um, which hasbeen really helpful,
(26:59):
particularly for milder injuriesthat are suitable for just a
repair.
So that's when we repair.
The native ligament back downand we don't add a new ligament.
Um, and adding the internalbrace to that adds some
biomechanical strength, makes ita little bit stronger, and then
seems to allow those repairs todo well.
The repair, when we were doingjust repairs without the
(27:20):
internal brace, they didn't doso well, but then we added the
internal brace, which gave alittle bit more biomechanical
strength.
Those seem to be, that seem tobe a pretty reasonable surgery,
um, for people who arecandidates and a little faster
return to play times.
We don't know the long-termoutcomes in terms of longevity
yet, but overall it's lookingpretty good.
Mike (27:40):
Mm-hmm.
Chris (27:41):
the problem is not everybody's a candidate for, for
the repair.
You know, guys that have massivetears, chronic attenuation,
tears at multiple sites of theligament, which to be honest, by
the time they're getting up inthe minor league, major league
type level, that's usually whatthese look like.
You know, they, they look like.
Pretty beat up low qualityligaments.
So I do still think there's roomand need for some innovation in
(28:02):
the reconstruction space, whichis reconstruction, which is what
we think of as traditional TommyJohn, when you're actually
adding a ligament in that, thatwe do need to evolve there.
And I think that adding theinternal brace to those
reconstructions, what a few ofus are starting to do now, and
we're seeing some promisingresults.
Mike (28:22):
That's.
Chris (28:23):
And, and I think that, that, that is sort of the
current status of things.
People are finding that, yes, ifthere's a way to reliably add an
intern brace to areconstruction, that seems to
help.
What I think though, is gonna bethe next big breakthrough, and
some of the things that we'reworking on is.
improving the biomechanicalstrength with addition of an
internal brace.
But what we really need to thinkabout is also improving the
(28:45):
biology of the construct and thesurgical technique to improve
the healing rate.
And it gets really complicatedreally quickly.
But I think that.
In order to have somethingthat's successful, that allows
for a quick return to play time,number one, and number two is
robust for the long haul.
We need to marry both thebiomechanical strength and the
(29:08):
biological activity, and if wecan find the way or find the,
the reconstruction techniquethat best optimizes both
biomechanical.
and the biology for healing,that's when we're really gonna
be able to make some, someinroads in improving these
return to play, uh, times andlowering revision rates.
Um, and there's several of usthat are working on that.
(29:29):
We, we have some, uh, I've beendoing a, a newer technique now
for the last three years, um,which, which does that, and I'm
really excited about it.
We're gonna be publishing that.
Uh, this year.
So I, I think that there's,there's a lot of exciting things
coming down the pike for, uh,for UCL reconstruction that I
think could be some potentialgame changers for us.
Mike (29:48):
That's great.
That's great.
And, and I do think we're, we'reprobably gonna have to take a
step back from our perspective,from the rehab perspective too,
and reanalyze a little bit ofour, our rehab procedures as we
start to transition to thehybrid.
Um, you know, but.
My limited experience with thesehybrid reconstructions are, you
know, they're, they're a littletighter.
Um, they, they feel tighter withrange of motion.
(30:09):
We don't want'em to lose motion.
And, and they almost have this,um, you know, this, this, this
tightness period in the throwingprogram that so far is resolved
and every, you know, people aredoing great, but it's different,
right.
And, you know, I've, I've seenso many of these that I know
what to expect.
So when somebody's like, ah, Ijust.
Tight and they point like almostto like, like the proximal end
(30:30):
of their ligament.
And you're like, oh, ah, we'lljust, we'll, we'll ignore that.
right?
Chris (30:35):
Right.
Yes.
Mike (30:36):
But, but you know, for us, we're, I think we're gonna have
to start, uh, I think we have todo the same thing.
We have to evolve our thoughtsand our techniques as, as we see
new, new surgical improvementsfrom yourself.
So, um, that's, that.
That's awesome.
Um, what else, what elsebesides, uh, elbow, what else
are you.
Chris (30:51):
You know, one of the things that I think is
interesting and it we're gonnafind as a big contributor to,
um, injury risk and trends isthat we are starting to measure
more things.
That players can follow.
So, lemme lemme explain that.
So obviously pitch velocity hasbeen measured forever and
there's always been a metric ofsuccess for baseball players,
(31:14):
whether you're little league,high school, college pro, that's
something easy to look at.
You know, it translates tosuccess and everybody is sort of
obsessed with pitch velocity andthat has probably, um, driven
some of the entry trends thatwe've.
Now we're starting to do somesimilar things in other areas,
uh, of the sport.
(31:35):
So now any high school player orcollege player has access to, to
different labs and, uh,facilities they can go into and
they can get their exit velocityfor a hitter or they can get
their sprint speed and, and Ithink, and they can get spin
rates and, and so I.
These metrics are incrediblyhelpful for us in improving
performance and predictingperformance, but they're also
(31:57):
gonna start to give us values.
That players, coaches and other,and parents will chase.
And if they start to chase thosethings similar to how they've
chased pitch velocity, I thinkthat that will probably be
driving some injuries, uh, forsome of these athletes.
So I think that, and, and someof this will be other soft
tissue injuries that we see inhitters.
(32:18):
Some shoulder injuries.
We know, you know, there's a lotof force in the shoulder during
the swing.
A lot of rota rotationalcomponents to this.
So BLE type injuries, hipinjuries, low back injuries.
So I think we're gonna see allof those start to evolve as we
start to give hitters numbersthat they can chase, just like
pitchers that have been chasingvelocity, uh, for many years.
Mike (32:40):
And, and I, I, I couldn't agree more.
I would say the last two, threeyears I've seen an uptick again
of, of, you know, what we callbatter shoulder.
But it's, you know, y you know,there's, I guess, numerous ways
you could define that, but it's,um, you know, that that
posterior instability of, of theshoulder and, and.
You know, at, at, you know, inmy head I'm trying to figure
out, okay, what, why is thisticking up a little bit?
(33:01):
And we, we do see it inaggressive fielders, right?
So like middle in fielders,center field, you know, that
probably have a history ofdiving and subluxations and
stuff like that.
Um, but then you look at.
All of these kids, like you justcome to my facility any evening
at 5:00 PM and look at all thekids Then in the winter that are
(33:21):
just working on max intent, exitvelocity and launch angle and
just like grinding, grinding,grinding, uh, you know, on top
of, of, of fielding.
And, and it's, it's interestingto see.
So, um, have you noticed that atyour level?
I, I have started seeing it inour pro guys too.
Um, but how, how much of thisbatter shoulder.
(33:43):
Is, is this just in my hands?
Is this a New England thing orare you guys seeing that too?
Chris (33:48):
We're, we're seeing it, and honestly, it's, it's sort of
following similar experience toTommy John.
Uh, you know, we're, we'restarting, we, we've always known
about it in high level hittersand professional hitters, but
I'm, I'm seeing it in collegehitters and I'm seeing it in
high school hitters, and I'meven seeing it in some youth.
I've, I've had some 12, 13, 14year old, uh, kids enter their
shoulders while batting, and soit's definitely, it's starting
to, to trickle up and we'restarting to see more.
Mike (34:11):
That's, that's, I, um, I'm glad you brought that up
because, you know, we, we alwaystalk about pitching injuries,
right.
And I feel like the positionplayers don't get enough.
But, um, you know, I, I'mdefinitely seeing batter
shoulders.
Uh, uh, what, what else inposition players, you know, I, I
know the data shows, you know,hamstrings, obliques, huge.
Um, are you seeing any trends inthat?
Are we getting better athamstrings?
Chris (34:33):
Yeah, I think so.
It's starting to look like it,so we're actually looking up the
MLB data again, uh, just to seehow it's going.
But it, it seems like we'restarting to do that, you know,
especially at the, at the higherlevels in the, in the major
league levels.
Interestingly enough, if you.
If you look back at some of theolder data, the, the most
common, uh, position forhamstring injury was pitcher and
the most common mechanism wassprinting to first base.
(34:56):
And so you gotta wonder, youknow, going to universal DH may
help that, honestly.
Um, so that, that may, you know,cause our hamstring numbers to
go down.
But I think people are gettingtuned into it, whether it's
doing different.
Um, eccentrics or Nordichamstring exercises are more
sprinting, timing, uh, timing,gauge jumping, those type of
things.
People are getting clued intoit.
And, and honestly, I think thehamstring is sort of a great
(35:17):
success story of whatepidemiologic research can do
for you.
You identify, Hey, this is acommon problem.
In fact, it's the number oneproblem.
Um, and it's not catastrophic.
They're usually not seasonending, but still, and these
guys are missing three to fourweeks on average for these types
of injuries.
And there's a lot of'em.
Let's see if we can fix it.
And then there are actualinterventions you can take to
try to improve hamstringplasticity and string and
(35:38):
explosiveness and, and I, and Ithink it actually is making a
difference.
So I think that's one of thesuccess stories, uh, that, that
we're having.
And now I think we're gonna seethe same thing in other areas.
You know, we know that obliqueinjur.
Core abdominal abdominal muscleinjury.
So sort of the sports hernia,the abductor, the rectus, that
whole area.
Um, we're, we're seeing thatvery commonly.
(35:59):
So I think those are probablygoing to be the next area that
we're gonna really have to tryto intervene on and, and reduce
injury numbers for.
Mike (36:05):
And call me crazy.
Same thing as bad or shoulders.
It's, it's probably because ofthe increased volume and
intensity of swinging that, youknow, we're getting in these
sport hernia type likesituations in low back and
spies.
I mean, we're, we're, you know,we're seeing the, the kids with
the stress.
Reactions.
It's, it's crazy how much we'reseeing these things nowadays.
So, um, you know, uh, superinteresting.
Um, all right.
(36:26):
Random question about this then.
So hamstrings, obviously we'reseeing ticking up a little bit.
You still take hamstring graftfor Tommy John's, or, or have
you started to, uh, you know, isthat, do you, do you care?
Is that, is that something thatcrossed your mind?
Do you try to go Polaris more ordoes that impact your decision?
Chris (36:41):
That's a, that's a great question.
I do my go-to graft, so I, Idefinitely prefer autograft over
allograft for, for UCL surgery.
So always, always, always, ifpossible, use the patient's own
graft, uh, just because there'sbetter handling properties, more
biologically active, um,improved healing, all of those
sort of things.
So for me, the Paul Marris isstill the go-to graft and the
(37:05):
vast majority of players have aPaul Mar.
Um, for that 10 to 15% thatdon't, then I will go to
hamstring and typically thegracilis, which is the smallest
of the hamstring tendons,there's some debate whether or
not you should use the landingleg or push leg, and we've tried
to study it.
Don't really, you know, have,have a great answer.
I tend to use the landing legrather than the push off leg.
(37:27):
But, um, we don't have any gooddata to support that.
So Paul Meis is still a graft ofchoice for 90%, uh, but then ham
hamstring for the rest.
The thing that's interestingthough is that oftentimes
players are now coming in with avery strong bias to what they
want.
So they may say, wait, I knowyou did this guy's surgery and
used a hamstring, and he'sthrowing.
(37:48):
I want, I want to use myhamstring.
And then you gotta sort of say,all right, let's back this up a
little bit.
Let's unpack and talk aboutthat.
Um, but in reality, if they havesuch a strong bias, you know,
towards something, it can beoften hard to overcome.
So I am finding that more sothan ever in the past, players
actually have a bias towardswhat they want to use, which is
important.
(38:08):
You know, you wanna inform'em,ultimate's, everybody though,
we, we've gotta, um, do do whatthey want, uh, but try to give
'em all the information theyneed to make those decision.
Mike (38:17):
That's funny.
Uh, y y you know, we did thesame thing with hamstrings and,
and kind of our subset ofpeople, and I would say with the
pitchers, I, I feel like we get.
Much, you know, lead leg istrail leg, hamstring injuries,
to be honest.
And, you know, that kind of,that, that impressed me a little
bit too.
I thought there would be more ofa pattern, but it, it, it seems
like they injure them bothfairly frequently.
Um, and I wonder again, if thenext evolution in baseball
(38:40):
pitching hamstrings here is, youknow, all the biomechanical
people, the pitching coaches,everybody's talking about lead
leg block.
Everybody's talking about this.
And, you know, I, for, for usfrom the medical side, we've, we
know what.
Lead leg block is, and how it'sa b biomechanical conclusion
almost, right?
But we, we literally now havekids like jamming their knee
into hyperextension, trying to,trying to work on lead leg block
(39:03):
instead of just getting theirforce of momentum over their
front side.
But, um, I, I wonder if that'sgonna be, you know, one of those
next things with, with thepitchers is the hamstrings on
the, on their front side fromjust worrying too much about the
wrong.
Chris (39:15):
Yeah, I think, I think it's a great point and, and you
bring up a, an interestingconcept here, Mike, and I think,
you know, we've seen howobsessed people have come become
with velocity because it's agreat predictor of performance
or it correlates withperformance.
And I've always wondered, isthere a way we can do the same
thing for sound mechanics?
So can we have some sort ofnumerical score or um, ability
(39:37):
to grade or judge soundmechanics.
That will reduce injury risk.
And is there a way that we canmake that measurable and
appealing to our young athletes?
You know, is there, is there away we can start getting them
to, they're always gonna chasevelocity.
We can't prevent that and that'sokay.
But can we also find some waysto get them to become obsessed
with and start chasing.
(39:59):
Sound mechanics, good strength,and, you know, good injury
prevention principles, that'shard.
You know, it's like teachingkids to eat vegetables.
They don't wanna do it.
It's gonna be tough.
You gotta find a way to make itappealing.
But I think that that issomething that we need to be
doing as a, as a, um,professional group.
Mike (40:18):
Yeah.
And, and it's funny though, you,you brought up the, the
perceptions here, and I was justlooking at this in a slide, but
a study from cross last year in,in 2022 that talked about
weighted balls and, um, uh,what, what was it?
Uh, 86% of of people responding.
Thought that weighted ballswould increase their velocity,
and 85% of them thought theywould increase their injury
(40:42):
risk, but they, they did itanyway.
Chris (40:46):
Right.
And, and we, we have torecognize that as medical
providers, you know, we, we tendto be very, um, injury risk
averse.
Much more so than our playersare.
And that's okay because we'reoffering a unique perspective
that they don't have.
But we also have to recognizethat if, if we just say, Hey, do
you know these things are gonnaincrease?
You know, such and such is gonnaincrease your risk of injury?
(41:07):
They'll probably say, yeah, Idon't care.
I'm gonna do it anyway.
And so we, we have to beprepared to understand that,
have that conversation and, andmeet'em in the middle and also
recognize that.
You know, some, except we allhave to accept some risk of
injury or we wouldn't be playingsports at all.
And so we just have to sort ofwork through what our threshold
is for injury risk and put and,and kind of marry that to the
(41:29):
injury risk threshold of theplayer and try to get on the
same page and help them and knowthat, you know, it's never gonna
be exactly what we want.
And it's never, maybe neverfully what they want either, but
we gotta try to work together tofind that that happy medium, it
gives them the balance ofoptimal performance and minimal
injury risk.
Mike (41:47):
Yeah, and I think I struggled with that a little bit
earlier in my career where.
you know, that I think thatwould bother me a little bit
more.
But man, I, I'm so much morehumble about that whole
experience with the players now,where I was like, look, I, I'm
just here to educate you andthen you hired me to help you.
Right?
That's how I kind of think ofyou, even though we're medical
right?
You, I, I'm here to help you.
I, I'm not gonna also adviseyou.
(42:08):
But I'm also gonna help you.
Right?
And that's the whole goal.
And, and even within baseball,sometimes sport science gets
that, that, you know, bad rapsometimes.
Um, but it's, it's aboutmaximizing your play between
those white lines and notlimiting it.
Right?
We're not trying to limit you,we're trying to get you as
prepared as we can and get yourcapacity as high as we can.
Um, and I think as a medicalcommunity, we have to embrace
(42:31):
that more so that way we getbetter buy-in from, from
everybody.
Right.
And, um, heck, I've, I'vedefinitely.
I'm probably labeled on Twitteras like a anti weighted ball
kind of guy.
And I'm not my, all my athleteslike use weighted balls to, in
extent, but we do it as, uh,intelligently as we can.
Um, you know, just because ourdata showed some negativity
(42:52):
doesn't mean that there isn't away we can apply it.
We just have to dose itcorrectly.
And that's just a concept thatmost people don't.
Chris (42:59):
Mm-hmm.
And, and I think it's true and,and our tolerance for risk as
medical providers is relativelylow, but we have to recognize
that for some of our players,you know, you, you've.
38 year old veteran who's stillwanting to play and is
struggling and they're saying,listen, if I don't pick up three
miles an hour, I've gottaretire.
So, and I say, I may say, Hey,this is really high risk for
(43:22):
you.
And they may say, if I don't doit, I'm done.
You know, my chance of playingare 0% if I don't do it.
So you're telling me, yeah, is ahigh risk of injury, but this is
the only way I can keep mycareer going.
Okay.
We have to understand that andbe okay with this.
All right, we're gonna do it.
Let's talk about how we can doit the right way, the smart way,
and try to try to get you betterwithout getting you hurt.
So we, we, that is often verydifficult for us to do, but
(43:43):
ultimately we have to recognizewe're here for them.
We're not here for ourselves.
We're, we're here for them.
And so we have to know whattheir.
Mike (43:51):
That's, that's awesome.
That's a great way of thinkingof it.
And yeah, we could, we couldtalk for hours.
This is amazing.
Um, I know you gotta get, uh,probably you're reconstructing
some ucls this afternoon at somepoint, so, um, uh, we, we could
keep going for hours.
Uh, before I let you go though,uh, we'd like to end with a
quick high five.
Where Five quick questions, fivequick answers.
(44:11):
Um, I, I love hearing this,especially from such well
established people likeyourself, just to show everybody
that you still have a growthmindset and all this great
stuff.
But, um, five quick questions.
First one is, what are youcurrently working on for your
own professional development?
Like your, what are you reading?
What are you learning for
Chris (44:29):
yeah.
Great question.
Yeah, so for me, actually, everyJan, I have a list of January
books that I reread everyJanuary.
So I'm, I'm a big reader, right?
And right now on the list, I'm,I'm going back through Marcus
Aurelius's, uh, meditation.
It's one of my favorite, I thinkI read it four or five times,
but I reread it every January.
It's, uh, A lot of wisdom.
Every time I reread it, I pickup new, new things.
Mike (44:50):
Is that, is that,
Chris (44:51):
I highly recommend it.
Mike (44:53):
I was gonna say, is that, is that your, is that your
number one book recommendationfor somebody that's, that's,
that's trying to work onself-improvement?
Chris (44:59):
No, that wouldn't be my number one.
Um, that, that one is usuallyit.
It's better sort of once you're,uh, partially down the trail and
you've sort of already done alittle soul search and you have
a little bit of an idea.
Um, cause it takes a little bitto, to put that one into
practical use.
Um, but in terms of like bestbook recommendations, a couple,
you know, you mentioned a growthmindset.
I'm a, I'm a huge Carol Dweckfan, uh, growth mindset.
(45:22):
I think Atomic Habits, uh, is,is a fantastic one for
developing systems andprocesses, uh, grit.
Fantastic.
Uh, peak and Owned by AndersErickson.
All of those are good.
I think it is sort ofestablishing yourself on a
pathway towards expertperformance.
Mike (45:37):
That's awesome.
Great stuff.
Uh, what's one thing that you'verecently changed your mind?
Chris (45:43):
Yeah, I'd, I'd say, um, I've always historically been a
very, very much a goal-orientedperson.
Um, but I've actually sort ofabandoned that in recent years.
Uh, and I really think thatsystems and processes, Trump
goals.
Um, every time.
Every time.
And so I, I have.
(46:03):
Essentially eliminated almostall goals, uh, from my life.
And I've worked to developsystems and processes that are
gonna help me get to the place Iwant to be and be the person I
wanna be.
So, uh, systems and processesover goals every, every day of
the week for me.
Mike (46:19):
That's awesome and I'm maniacal about that as well.
You can ask everybody I workwith, right?
We have.
So many, uh, uh, standardoperating procedures for
everything written up.
Uh, once it starts blending intoyour personal life though, and
you have a system for likemaking coffee in the morning,
that's when, when your wifestarts to get, uh, agitated with
you, but but, uh, but yeah,
Chris (46:39):
my wife could definitely, uh, could definitely share that
frustration.
Yeah,
Mike (46:43):
Once you, once you start thinking systems, you can't
think anything else.
Right?
Even you go to a restaurant andyou're like, the, the, all the
systems are all broken here.
I can't, I can't
Chris (46:51):
This is how they should be doing this.
Yeah.
This, this.
Mike (46:54):
That's why, that's why you're a leader.
Um, all right, next question.
What, what's your favorite pieceof advice that you give
residents?
Chris (47:00):
Yeah.
So my, my key, I, I try to makeit as simple as possible, and I
tell'em, always stay humble,hungry.
Those are the two.
If you, if you needed twoadjectives to describe yourself,
humble and hungry.
And I think that's true of anyyoung, professional or older,
professional, uh, in the world.
If, if you're humble, you're aperson who's got, An open mind,
you're responsive to criticism.
You've got a growth mindset.
(47:22):
You're gonna be a better teamplayer.
People are gonna enjoy beingaround you, and your ceiling is
much higher.
And obviously, if you're hungry,you're gonna, you're gonna have
the energy, you're gonna bemotivated, you're gonna do the
things you need to do, you'regonna be doing, you're gonna do
the stuff that others are notwilling to do.
You're gonna do the hard work,you're gonna have the high
tolerance for boredom.
And I, and I think that'ssomething for younger people to
(47:43):
think about, especially ifyou're trying to get into
baseball.
Oftentimes you think you'regonna come in and it's gonna be
glitzy and, and, and it's gonnabe a lot of glamor.
And in reality it's not.
And, and nothing in life is,and, and I think it's the people
who have the high tolerance forboredom.
Are the ones that can beextremely successful.
So can you keep doing the rightthings every single day, day in,
day out, over and over and overand over and over again, and
(48:06):
stick with it.
Um, those are the people thatare gonna be successful.
And I, I think that, so stayinghungry, humble, uh, would be my
two pieces of advice for any,any young professional or
somebody that's been at it for awhile and needs to freshen
things up a little bit.
Mike (48:19):
I like.
I like it.
And then follow up with that me.
I think you're, you're in a goodspot right
Chris (48:24):
Exactly.
Exactly.
Yeah.
Yeah.
Mike (48:26):
Alright.
What's coming up next for you?
Chris (48:29):
Yeah, so spring training's right around the
corner, so always excited aboutthat.
Um, so we got that coming up.
And then also a couple newthings in the, in the research
world that I'm pretty excitedabout.
We're, we're gonna start, youknow, people have seen, uh,
marker based motion capture ofthe pitching motion.
Uh, we're starting some studiesdoing it for the baseball swing.
We, we talked about that earlierwith the obsession with ex exit
velocity things.
(48:49):
So we need to figure out moreabout the, the forces that are
happening throughout the body,through the swing.
Got that coming up.
And then another thing that I'mreally interested in, and we're
starting to, to use in some ofour research is using different
machine learning and artificialintelligence approaches to try
to sort out some of these issuesaround risk prediction, uh, risk
mitigation for injuries andthose types of things.
(49:11):
So those are the few of thethings coming up that I'm, I'm
really excited about.
Mike (49:14):
That's awesome.
I, I'm really looking forward tolearning from that, from you.
So.
Awesome.
Um, where can people learn moreabout you obviously go to
PubMed.
Type in your name and, andthat'll give you a, a few months
of reading.
But, uh, where, where else is,is there a place that they can
find you if, if they wanna senda patient to you or anything?
Where, where can people findmore about you online?
Chris (49:34):
Yeah, a couple spots.
Um, so yeah, all, all ourresearch is on, uh, PubMed.
Uh, our website is, uh, sportsmedicine dot mayo clinic.org.
So if you wanna just go to theMayo Clinic Sports Medicine, uh,
Google that you'll find it, thatsort of tells you all about our
clinic and how to get patientsin and what we have to offer,
those sort of things, if youwanna do that and.
I'm also moderately active onTwitter, trying to share
baseball injury research andsurgical techniques and things
(49:57):
like that.
So at Chris Camp md, uh, is theTwitter handle.
So either of those spots willwork.
Mike (50:02):
Yeah, and I will say you are a great Twitter follow, um,
cuz you're.
Posting really good stuff andyou're active.
Right.
And it's, it's, um, you know, II think sometimes people, uh,
don't, uh, appreciate thatenough, right?
To, to be able to interact withsomebody like yourself on
Twitter is, is priceless.
So, uh, so take advantage andfollow'em and, and ask questions
and, um, it's, it's a greatexperience.
(50:23):
So, um, well, thank you so muchDr.
Camp.
That was amazing.
Um, good luck this season.
I, I hope, hope to, to see you,uh, at some point during the
year.
But thanks so much for coming onthe show and giving so much of
your perspective.
Is amazing.
Chris (50:37):
You got it, Mike.
Really appreciate it.
I, I enjoyed it.
As always, enjoy listening toyour podcast, so it's an honor
to be a part of it.
On this episode of the sportphysical therapy podcast, I'm
joined by Dr.
Chris camp.
Dr.
Camp is an orthopedic surgeon atthe Mayo clinic in Rochester,
Minnesota, and is the medicaldirector and director of high
performance for the Minnesotatwins.
Dr.
Camp's a prolific researcher inthe field of baseball injuries
with an enormous amount ofpublications.
And this episode, we're going totalk about building a high
(00:20):
performance team andprofessional baseball.
And how we can predict andmitigate injury risk, and then
some of the trends in injuriesthat he's seeing in baseball.
Mike (00:40):
Hey Dr.
Kemp.
Thanks so much for joining us onthe podcast today.
Really appreciate you, uh,taking some time outta your, uh,
I'm sure hectic schedule isyou're getting ready for the
baseball season.
But thanks so much for joiningus.
Chris (00:50):
You got it.
Mike.
Thanks so much for having me.
It's a, it's an honor and apleasure to be here.
Mike (00:54):
That's awesome.
Um, I, I recently had an episodewith Dr.
Brandon Erickson, and I had avery similar introduction with
him where I said, gosh, wecould, we, I don't know how you
do this much research inbaseball injuries, and we could
talk about about a thousandthings.
But we are super thankful forall you're doing because you've
really helped us understandbaseball injuries so much more
(01:16):
with just your, your mounds andmounds of research that you guys
published.
So thank you for all that youdo.
Chris (01:21):
Oh, you got it.
I l love to do it.
And obviously, you know, Brandonand I are good friends.
We work together on a lot ofthings too, and he and I share a
similar passion.
You know, there's a, we, we'vegot a lot to figure out.
Um, and I, we feel like we'rejust getting started.
We're just sort of hitting thetip of the iceberg.
So very excited about what we'vedone so far, and even more
excited about what lies in thefuture.
Mike (01:40):
Do you ever look at the research and think to yourself
that, wow, like we, we feel likewe're advancing ourselves, but
the more we dig into it, themore we realize that injury
rates just keep going up and upand up and we're, we're
ultimately failing, right?
Chris (01:51):
No question.
And that, that's one of thefunny things about research too,
is I always tell folks if you,if you do a really good job
designing a, a study and youconduct that study, it gives you
an answer to a question.
And then it gives you three morequestions.
And so I, I feel like we arelearning more, but we're also
learning more.
We're also learning how much wedon't know.
The more, the more of this we dotoo.
(02:12):
So there, there's a lot of, uh,job security in it for sure.
Mike (02:15):
Yeah.
You know, and I, I think yousaid that really well too.
If you even just look at y youknow yourself and others, but
you know the history of some ofthe data that we're getting from
Major League baseball injuries,we're seeing it progress from
like broad strokes.
Like, you know, you know,demographic, uh, epidemiology
type things based on, you know,simple demographics and stuff
like that, um, to now gettingmore specifics.
(02:36):
So I, I think you're right.
I think over time we are gettingmore and more out of all this
data that hopefully continues tomake progress, but we'll see.
Right.
Chris (02:45):
Yeah, absolutely.
And I think you always have tostart with the.
So you, you always wanna askwhat's going on out there?
What, what are the injuries?
What's really happening?
What is impacting players?
And, and that's sort of whatthe, the first phase or wave of
the MLB research has done forus.
It's kind of told, told uswhat's happening, uh, now the
next question we have to startasking is why.
(03:08):
And, and then we have to ask howdo we fix it?
So tho those are the harderquestions that are, that are
coming up for.
Mike (03:15):
Well, you, you, uh, what I'm excited about is that people
like yourself are behind these,uh, endeavors in the future
because, I mean, we, we've seenthis in the past when, when all
you see is injured baseballplayers.
Then sometimes it skews yourperspective a little bit.
And what I like about yourselfnow you're, you know, you're
currently the director of highperformance, the medical
(03:35):
director of for the twins,right?
So you are not just seeinginjured players, you're seeing
healthy players, and you'reseeing players that not only
wanna prevent injury, but wantto enhance performance.
Right?
So, you know that perspective tome, I.
Gives you a, a, a better, abetter approach to your
projects.
Right.
And I think we're starting tosee that when, when you start
(03:55):
publishing things that, youknow, I can see that at least
where, where you're coming from.
Chris (04:00):
Yeah, that, that's a great thought, Mike and I, and I
think it's true.
I think for all of theseproblems, the the solutions are
gonna lie in.
Bringing together people whohave broad perspectives.
Each one of us sort of has ourown biases and ways of looking
at things and our own pastexperience that shapes and mold
us.
And because of that, no oneperson has all of the answers.
(04:21):
And, and so I think to figureout these relatively complex
things, we've got to bringtogether people from.
Diverse backgrounds,experiences, diverse ways of
looking at things because we, wesort of need to look at these
problems from a 360 degree viewall, all the way around, and
that's the only way we're reallygonna be able to make any
serious headway on
Mike (04:40):
I like that and, and it really sounds like that is what
you put behind your current.
Role with the twins.
Um, and you know, I, I, I, Ilike your title.
I thought that was nice too,because most orthopedic surgeons
are either team physicians ormaybe they're, uh, you know,
head surgeon or medicaldirector, but you added director
of high performance to that.
And I think that speaks volumesabout probably what yourself and
(05:04):
the organization are thinkingabout our department now.
It's not just health, but alsoperformance.
Um, tell us a little bit aboutthat role that you play with
the.
Chris (05:12):
Yeah, absolutely.
So, so I think most people aresort of familiar with the team
physician role, um, coveringgames, taking care of injuries
that they come up, and also sortof familiar with the medical
director role.
So trying to make medicaldecisions about injuries and
illnesses across theorganization.
But the.
The high performance role I, Ithink, is a little bit unique,
uh, for us ev Most teams nowhave some sort of.
(05:36):
Director of Sports Science or,you know, some, something along
those lines.
But with this, what we've puttogether in, uh, this role of
director of high performance isreally something that we have
been thinking about for severalyears.
Uh, myself and some of the folksin the front office, Derek
Fowley, FA Levine, about how wecould really shape the, the
entire department.
And for us, what we define asthe, the High Performance Group
(05:59):
is not just folks in.
Um, not, not just thephysicians, but also our
athletic trainers, our physicaltherapists, strength and
conditioning.
Our dieticians and nutritionistsmassage the.
Uh, sleep hygiene folks, mentalskills, sports psychology,
chiropractors, sort of everybodyin in that group.
And, and it's a, it's a biggroup.
(06:19):
It's a diverse group.
We all have a different way oflooking at things, but
ultimately we need to, to try tounify our, our vision, and
that's kind of how we see that.
In.
In addition to that, we're alsostarting to bring in more of
the, the sports size people, theresearch and analytics, uh, into
that same space as well.
And I think for any of us to besuccessful in this area, we have
(06:40):
to recognize that no one personhas all of the answers.
Um, no matter how good you are,how much you've done, or what
your experience is, you, you'restill very limited.
And me as an orthopedic surgeon,I, I could spend the rest of my
life, you know, studying and Istill wouldn't be nearly as good
as our strength and conditioningcoaches that have already been
doing it for so many years.
(07:02):
Right.
And so I can't pretend to havedomain expertise in that area.
Um, even if I think I reallylike it and I pay a lot of
attention to it, and I, and Istudy it extensively, same
thing.
You know, I can't.
Even begin to imagine havingdomain expertise in the, in the
world of sports psychology.
I, I know a little bit about it.
I'm interested in it.
I think it's criticallyimportant, but I'm not an expert
(07:23):
in it.
And so really in that role, I, Isort of view myself as kind of a
coordinator of experts and, andthat's really how we've tried to
shape it, um, with, with thetwins organization.
So it's, it's not one personwho's, uh, completely in charge.
We're a team of equals,everybody's sort of on the same
page, the same level.
Uh, there's sort of minimal.
Hierarchy to it.
(07:44):
Everybody has a seat at thetable.
Um, and we care about whateverybody thinks.
And, and I think that taking anapproach like that is definitely
difficult at times.
Um, it's a little bitcounterculture.
To a lot of organizations andbaseball in general.
So it, it's definitelydifferent, but I think that it
is, it, it's worth doing it.
It certainly comes with some,some nuanced, uh, headaches and,
(08:08):
and, uh, problems, but I thinkthat those are all worth having
and worth sorting throughbecause if we're ever, if we're
ever gonna get it, we're gonnahave to get it together and
we're gonna have to gocollectively as a team.
Mike (08:18):
That's awesome and, and totally refreshing to hear, um,
what, what I like more thananything else was just listening
to that from your perspective.
To me is this is what makes youa great team physician.
Right?
And, and not every doctor is thebest.
And just like, not every, anyprofession is, is great, but the
understanding of the role of ateam physician, it's not a
(08:40):
dictatorship.
It's not an ego trip thing.
It's, it's, it is about beingthere for the players and being
there for leadership.
Um, I, I just think the way yousaid that was, So excellent
that, um, I really hope a lot ofpeople get to, uh, you know,
experience working with a, aphysician like yourself in this
environment because that'sexactly what we need, right?
We are, we're evolving as agame.
(09:01):
We're evolving as all theseinterdisciplinary people like
work together and, and it'soppressive thing that you guys
are building with the twins, weput all those people together.
It wasn't that long ago that aa, a big.
Medical staff was a head trainerand assistant trainer and one
strength coach.
And that's it.
That was, and I'm talking aboutlike single digit years ago,
right?
Like that wasn't, that wasn'tdecades ago.
(09:23):
Right.
And look at how much you guyshave built.
So when you started with thetwins, where, what was, what did
the department look like andwhat does it look like now?
I know you kind of alluded tolike all those different people,
but how have you seen that grow?
And the reason why I ask that isbecause I think a lot of my
listeners are very eager to getinto pro sports, and I like how
there's so many differentavenues now to get there.
(09:45):
It's not just, oh, you have tobe an athletic trainer.
There's, there's 10 differentprofessions that you just listed
right there that can get inthere.
But tell us a little bit aboutthe evolution of the twins,
because I think we're gonnastart seeing that more and more
with other.
Chris (09:58):
Mm-hmm.
Yeah.
So, and that's a great thoughtand, and I think our evolution
has probably mirrored that of alot of other organizations in
that, you know, let's say fiveyears ago we had components of
strength and conditioning and.
Athletic training, physicaltherapy, nutrition, a little bit
of sports, psych and mentalwellness.
We, we sort of had all of thosecomponents, um, some of them
(10:21):
more robust than others.
And so I, I think that ourbiggest evolution has, has not
necessarily been adding newdomains to the team, but
actually expanding.
Each of those domains andcollectively bringing them
together.
That's it.
So, so we now have, we'vealways, we, you know, we've had
strength and conditioning for awhile.
(10:42):
We now have more strength andconditioning coaches.
Mike (10:44):
Right.
Chris (10:45):
We've also sort of changed the structure and the
hierarchy with within the, thestrength and conditioning area
and within the physical therapyspace and, um, and, and in all
of our spaces, um, to create, tocreate a system where there's a
lot more coordination withinthat domain and across all of
the other domains and incollaboration.
(11:05):
So I think our biggest evolutionhas not just been growing in
numbers and size.
But more so growing incollaboration and making sure
that everybody understands whateverybody else is doing, what
they're capable of, what theirskill sets are, where their
shortcomings are, you know, howwe can help them make up for
those and, and those sort ofthings that that's been the
biggest focus of our evolutionover the last several years.
Mike (11:28):
That's fantastic.
And, and I, I, I like thatprogression.
That's something that, um, I'vebeen trying to build with the
White Sox myself.
Too.
I mean, we're al Centralcompetitors here.
We shouldn't be giving eachother secrets maybe.
But, uh, it's, uh, the, um, uh,you know, the concept of a
leadership tree, and I thinkthat's exactly what you just,
you know, provided a frameworkfor right there.
(11:49):
It's the same thing, but is thatwe have a bunch of peers.
That are all within leadership,right?
It's not a dictatorship.
It's not like one person typething.
It's about how do we put all ourheads together and how do we
collaborate and how do we leavea room where we're planning on
something?
Anything a a, a strength andconditioning program, a a prep
work.
Program, a rehab program for oneplayer, how do we leave that
(12:11):
room in unison where everybody'shad a chance to talk about it?
Everybody's had a chance tovoice their perspective, which,
which often changes the overallprogram.
Um, it's, it's really, reallyawesome to kind of hear that and
see that.
And I have a lot of friends thathave come through the twins
organization that speak reallyhighly of it.
So, um, you know, again, kudosto you for, for seeing this and
for, you know, emulating thisfor some of the peers that
(12:32):
you've worked with around theleague.
Um, it, it just sounds like youguys are doing a great.
Chris (12:37):
Good.
Well, we're enjoying it.
And you know, we're, we'reseeing some, um, some dividends
pay off too, so it's been great.
We're gonna keep at it.
It's obviously, it's a lot ofhard work.
It's anytime you're changing,you know, the culture of, of
baseball.
With an organization can, it canbe difficult.
But, uh, it has been very good.
We've made some tremendousprogress, so we're, we're
excited about where we're at nowand where we're headed in the
future.
Mike (12:57):
That's awesome.
That's awesome.
And it, and it helps that youhave a great front office and
you have a great manager.
Right?
A modern think manager.
I mean, it's, um, it's, it'sit's support, right?
That's, that's what you need inyour role is support from
everybody, from field staff,from front office, from data
analytics.
It's, it's, that's what, what'sthe glue that keeps everything
together?
Is that everybody's on the samepage.
Chris (13:19):
A hundred percent.
And, and that's a lot of whatwe're trying to do is, you know,
we're breaking down silos notonly within the performance
space, but also within the wholeorganization.
So we we're very blessed in ourorganization in that we do, we
have a front office that sort ofbelieves in this model.
We have a manager that believesin this model, and I think part
of our job, in the performancespace is that we have to reflect
(13:40):
the culture of the other areasin the clubhouse.
So a player needs to be able toflow freely from the dugout to
the clubhouse or locker room,into the weight room, into the
athletic training room.
With that same sort of feeling,that same sort of culture, that
same sort of vibe, that sameenergy in all of those spaces.
(14:02):
You don't want'em to all of asudden come into the athletic
training room and think, oh no,this, this is where I have.
Do X, Y, Z or I gotta change mybehavior in this space, or I
gotta act a certain way in thisspaces.
Now we, we want the whole thingto sort of have the same, same
feel and vibe.
And I think that's reallycritical for our players in
order to be comfortable tounderstand what we're doing to
buy into the programming that wehave.
(14:23):
And you can't do that without asupportive coaching staff, front
office staff and players, uh, tobe honest.
And we're, we're blessed to haveall of those.
Mike (14:31):
Sure.
And, and great leadership fromyourself too.
I mean, to give yourself some,some credit here, it's, it's
putting that glue together aswell.
So, um, um, great stuff.
Um, one of the biggest rolesthat these departments play,
right, is in risk.
Mitigation, right.
Injury prevention, injuryprediction.
Even.
Um, you know, some people referto this, you know, 20 years ago,
(14:51):
you know, uh, you know, we, wewere talking about this as the
money ball for, for medical,right?
Where we started taking data andtrying to, to, you know, predict
and prevent injuries.
Um, what, what do you think therole of your department is for
injury prediction in riskmanagement?
Not, not just prevention, butprediction.
How have you guys workedtowards.
Chris (15:10):
Yeah, that, that's a, that's a great question.
And honestly, you know, it'spart of the, part of the holy
grail.
It's, it's complex, it'sdifficult, but in reality, one
of the things I've always talkedabout is if you look at our
research and analytics team, Ithink this is the same.
This is true of everyorganization.
They do a phenomenal job ofpredicting on field performance
of players.
(15:31):
They have a pretty good idea.
It's never perfect, but they,with some reasonable accuracy,
can predict the number of wins.
A team will have the predictedwar of this player, that player
wins losses, starts batting atthose sort of things.
They, and they do a remarkablygood job.
It's never perfect, but it'spretty good.
And so one of the questions I'vebeen asking myself is, why can't
(15:51):
we do the same thing?
Health and injuries.
You know, why, why can't we?
And we haven't been that greatat it in the past, but I think
we can be.
I, I, I really do.
I I truly confidently, uh,believe that that is the case
and we're gonna get there.
Um, but it's not easy.
And, and I think in, in my mind,there's, there's really
(16:12):
probably.
Five major steps that we have totake in order to start talking
about risk, uh, our injury, riskprediction and mitigation.
And I think number one, we haveto first define the problem.
Uh, and we've been spending alot of years doing that, sort of
identifying what are the biginjuries?
What are we actually missing outon?
And then second, I think we haveto think about once, once we
(16:34):
identify the.
We have to recognize which ofthose problems we can actually
influence.
You know, there are certaininjuries that we probably will
never control.
Um, liner comebacker to thepitcher, hits'em in the auto
fractures.
You, you can't predict that.
You can't control that.
Don't waste your time, you know,on that.
So, so figure out which, whichof the injuries can you actually
(16:55):
influence and.
Once you do that, the, the thirdstep is sort of identifying all
of the factors that contributeto that injury, which is
difficult, and that, that sortof takes that approach across
all of the different domains.
Um, and I, and I think that'svery complex and very quickly
you start running into a lot ofinformation and a lot of data
(17:16):
because, you know, some of thethings that contribute are prob
their, their movement patterns,their strength, their diet,
their sleep, their workload.
um, their overall performance,their running speed.
I mean, all of these sort ofthings contribute.
So you sort of have to figureout all the factors that
contribute.
And then once you do that,fourth, you have to figure out
which one of those you canintervene on and modify.
(17:39):
And I think that has to reallybe individualized to the player.
Um, because some players you canmodify certain things or
intervene on certain things.
Other players, they, you may notbe able to modify that.
Or if you do, Lowers theircompetitive balance and you
know, that's not somethingthey're willing to do.
So you sort of have to identifythose factors and actually
intervene.
And then the fifth and finalthing I think that we have to do
(18:01):
is that we have to continue tomeasure our progress and then
adjust.
So, you know, you, you gothrough all of these steps and
you say, okay, did we actuallymake a difference here with
this, with the injury?
We identified the steps theycontributed to at the
interventions we interact, we.
Now, did it work?
What, what's the difference?
And if so, great.
(18:23):
Now how can we incorporate thisinto the normal routine?
If not, let's go back to thedrawing board, try it again.
And, and it's sort of that fivestep iterative process that you
just have to keep going through,over and over and over again,
um, to infinity really, to, totry to figure it out.
Mike (18:38):
And, and just when you think you've, you've figured
something out.
You, the unexplainable happens.
The, uh, extra inning game, the,the.
West Coast Road trip, althoughthat's not as exciting for the
Al Central as it was for the ALEast.
But there's, you know, there, Idon't, I, I try to tell people
this all the time, but somepeople don't realize this.
You know, we play, I, I, what isit, 162 games in 180 days.
(18:59):
And I try to explain to peoplelike, you wake up, you go to
work, you come home, you know,you turn on the twins game.
great.
You know?
Then next day, you know, youwake up, you go to work, you
come home, you turn on the twinsgames, like, wait a minute, now
they're, now they're in Tampa.
How'd they get to Tampa?
Like, like, like how, how'd thathappen?
Be like, people don't, peopledon't appreciate the stresses
that go into the body here, andwhen you have to play every.
(19:21):
Day, like every single day.
It's, it's super challengingbecause the players, if, if
they're not performing well,they, they wanna practice more.
They wanna take extra reps inthe cage, they want to throw
more in the pen.
And that's almost like the, thatfine balance between workload
and capacity that they'redealing with at all times over
the year.
That like we can do as best aswe can.
(19:43):
And then you just get thrownsuch a curve ball.
You can't control everything.
It's frustra.
Chris (19:49):
It, it's extremely frustrating and we, we've all
seen that too.
You know, you, you get theplayer that you know needs some,
some rest and you show you tryto work, give him a day off.
Then you go in the weight roomand you find I'm just crushing
the weights for three hours.
Like, it, it would've been lesswork had you played today.
You know, this was notdifficult.
So, yeah, it, it is tough and,and also too, The other thing
that's hard is that if you lookacross injuries, uh, as the
(20:13):
entire professional baseballworld, you know, that's about
7,000 or so players.
So you have a pretty largedenominator to look at injury
trends and things.
If you look at it within asingle team or just within a
major league, an active majorleague roster with 26 or so
players, it's a really smallsample size.
And so having that small samplesize makes it difficult to know
(20:37):
when I see injuries, you know,ticking up.
Is this a true trend?
or is this just randomrandomness?
Because we have such a smalldenominator, it, it does make
the, the comparisons are prettyfragile, so you have to be
really careful not to overread,um, into negative trends or give
(20:58):
yourself too much credit ifthings go well.
You know, because
Mike (21:02):
that's, that's great.
Chris (21:03):
every year, I mean, sometimes you're just a couple
of injuries, one to twoinjuries.
From having a terrible injuryridden season versus the best
season you've had in years.
So it's such a fine balance andwe have to be very objective
about how much of that weactually control to the positive
and the negative in, in bothdirections, which I think also
makes this more complicated andcomplex.
Mike (21:25):
That.
Absolutely.
So in your position, in, in yourresearch, you've done a lot
about, um, tracking trends.
In injuries in baseball, and Icould say over my almost 25 year
career right now, the, theinjuries that I was seeing in
the first half of my career aredifferent than the injuries I'm
seeing now in my second half ofmy career.
(21:47):
Uh, it's almost like the gamesevolved.
The the players have evolved,their practice patterns have
evolved and their injuries are,uh, evolving with.
And you know, it's, it's funnywhen, when you see that, because
you still see some outdatedthings based on some of the, the
information we had 20 years ago.
Uh, but I'm curious from yourperspective, somebody that's not
(22:08):
only on the inside every daywith the team, which is an
amazing resource for your ownknowledge, um, that I'm sure you
appreciate, but like, don't evertake for granted that you.
Best Petri dish in the world isthose 300 baseball players that
you take care of.
Right.
But, um, uh, in your perspectivebetween that and the data
collection that you're seeingfrom Major League Baseball, what
(22:28):
are some of the, the, the trendsthat you're seeing, some of the
things that are evolving, whatare we, what do you think we
might start seeing more of?
I, I'd love to just, you know,you know, and I hate to give you
such a crazy vague, open-endedquestion, but let's, let's start
chatting
Chris (22:42):
Yeah, absolutely.
So, uh, that's a great questionand I think there's a lot of
different ways we could takethis.
And I mean, one of the mostinteresting and obviously the
most sort of publicized, um,injury trends that we see is
that of Tommy John injuries or,you know, media honor,
collateral ligament injuries.
And for years and years we'vejust talked about, oh, rates are
going up, going up, going up,going up.
(23:04):
But I think we're at a spot now.
It's a little more complicatedthan that.
And, and actually if we lookwithin the last few years, what
we've seen is we've actuallyseen a slightly lower frequency
in Major League players withTommy John injury, which is
great.
And there's a tendency to stopand say, Hey, we're doing a good
job.
Let's pat ourselves on the back.
We've
Mike (23:24):
Right,
Chris (23:24):
thing out.
Mike (23:25):
right.
Chris (23:25):
there's even, there's been a few And, and there's even
been a few articles that havebeen printed to that effect.
But then if we really look atthe data, what we see is,
Although Major League, Tommy,John injuries are going down the
minor league, injury rates aregoing sky high.
Mike (23:42):
Enormously Enor, and that's one of my favorite graphs
that you show.
That, that I've, I've used that.
Stan, let me borrow one of yourgraphs, I'm sure.
But, um, like omg, we talk aboutthis Tommy John injury.
Epidemic, right.
That, that, that we have inmajor league baseball and it's
nothing compared to the lowerlevels, minor league baseball.
And heck, I, I, from myperspective of what I see in my
(24:03):
practice college in high school,it's the same thing.
They're going crazy.
So it's funny you said that,that, you know, we, we pat
ourself on the back for a hotsecond there about Major League,
but it's just that they'rehappening earlier.
Chris (24:13):
Yes, exactly.
And that, and that's what'shappened.
So they're getting shifted toyounger ages, whether that's
minor league college, and noweven starting to be in the high
school.
And what I worry about with thatis that as those.
The rates of primary Tommy Johnsurgeries and first time Tommy
John injuries starts to shiftdown to the younger players.
If in response to that on theback end with the major league
(24:37):
players, we're gonna start tosee an uptick in the number of
secondary Tommy John injuries orrevision Tommy John
Mike (24:43):
Sure.
Chris (24:44):
So I think we're already starting to see that now.
Where?
Where, yeah, the number ofprimary surgeries is.
Probably down in the majorleagues, but the number of
revisions are ticking up andthat's because now guys are not
having their first Tommy John asa major leaguer.
They're having it as a minorleaguer or a college or even a
high school athlete.
Mike (25:03):
Yeah.
Wow.
Chris (25:04):
it's becoming revision time by the time they get to the
leagues.
So I, I think that is somethingthat we're probably going to see
and then that opens up a wholenother can of worms is how do
we, how do we handle theserevision cases, which we know
are a little bit tougher andharder to rehab and less
predictable?
And so I think this problem'sgonna get harder before it gets
easier.
Mike (25:23):
And I remember too, we used to say that, uh, Tommy John
lasts like 10 years, right?
And we were doing them in 32year olds, right?
That that was, that was 20 yearsago.
And we'd say like, nah, thiswill, this will last longer than
your career.
Then we started saying, okay,maybe they last like seven or
eight years, and now we're like,okay, maybe they last like.
Five years Right.
So it's, it's like they're eventrending that way.
But you know what, I think we'reat a really great spot though
(25:45):
for this to occur because wehave some options now, right?
We have the new internal bracewith the repair, um, even some
hybrid techniques and know youand I have, we've shared
patients that have had arevision with, with the internal
brace that are still doingoutstanding several years later.
So, um, where do you see thatevolving?
Where do you see that cominginto?
Chris (26:06):
Yeah.
And, and I think that this is anarea that is ripe, uh, for, for
some advancement.
You know, if you, if you thinkabout the most common surgical
techniques for Tommy John'ssurgery are the, uh, figure of
eight of the modified jobtechnique and the docking
technique.
And both of those were describedin the early two thousands.
2001, 2002.
(26:27):
So almost 20 years.
And not a ton has changed, andthere's hardly anything in
orthopedic surgery that we'redoing the same now that we were
doing 20 years ago.
Mike (26:37):
That's a good point.
Chris (26:38):
but this, that has been the case for that surgery.
And that's, and it's not from alack of trying.
People have tried, there's allsorts of different techniques
that have been described outthere that just didn't quite pan
out.
Nobody's really been able tofigure, figure out what the next
level is.
And then in recent years, we'veintroduced the concept of the
internal brace, um, which hasbeen really helpful,
(26:59):
particularly for milder injuriesthat are suitable for just a
repair.
So that's when we repair.
The native ligament back downand we don't add a new ligament.
Um, and adding the internalbrace to that adds some
biomechanical strength, makes ita little bit stronger, and then
seems to allow those repairs todo well.
The repair, when we were doingjust repairs without the
(27:20):
internal brace, they didn't doso well, but then we added the
internal brace, which gave alittle bit more biomechanical
strength.
Those seem to be, that seem tobe a pretty reasonable surgery,
um, for people who arecandidates and a little faster
return to play times.
We don't know the long-termoutcomes in terms of longevity
yet, but overall it's lookingpretty good.
Mike (27:40):
Mm-hmm.
Chris (27:41):
the problem is not everybody's a candidate for, for
the repair.
You know, guys that have massivetears, chronic attenuation,
tears at multiple sites of theligament, which to be honest, by
the time they're getting up inthe minor league, major league
type level, that's usually whatthese look like.
You know, they, they look like.
Pretty beat up low qualityligaments.
So I do still think there's roomand need for some innovation in
(28:02):
the reconstruction space, whichis reconstruction, which is what
we think of as traditional TommyJohn, when you're actually
adding a ligament in that, thatwe do need to evolve there.
And I think that adding theinternal brace to those
reconstructions, what a few ofus are starting to do now, and
we're seeing some promisingresults.
Mike (28:22):
That's.
Chris (28:23):
And, and I think that, that, that is sort of the
current status of things.
People are finding that, yes, ifthere's a way to reliably add an
intern brace to areconstruction, that seems to
help.
What I think though, is gonna bethe next big breakthrough, and
some of the things that we'reworking on is.
improving the biomechanicalstrength with addition of an
internal brace.
But what we really need to thinkabout is also improving the
(28:45):
biology of the construct and thesurgical technique to improve
the healing rate.
And it gets really complicatedreally quickly.
But I think that.
In order to have somethingthat's successful, that allows
for a quick return to play time,number one, and number two is
robust for the long haul.
We need to marry both thebiomechanical strength and the
(29:08):
biological activity, and if wecan find the way or find the,
the reconstruction techniquethat best optimizes both
biomechanical.
and the biology for healing,that's when we're really gonna
be able to make some, someinroads in improving these
return to play, uh, times andlowering revision rates.
Um, and there's several of usthat are working on that.
(29:29):
We, we have some, uh, I've beendoing a, a newer technique now
for the last three years, um,which, which does that, and I'm
really excited about it.
We're gonna be publishing that.
Uh, this year.
So I, I think that there's,there's a lot of exciting things
coming down the pike for, uh,for UCL reconstruction that I
think could be some potentialgame changers for us.
Mike (29:48):
That's great.
That's great.
And, and I do think we're, we'reprobably gonna have to take a
step back from our perspective,from the rehab perspective too,
and reanalyze a little bit ofour, our rehab procedures as we
start to transition to thehybrid.
Um, you know, but.
My limited experience with thesehybrid reconstructions are, you
know, they're, they're a littletighter.
Um, they, they feel tighter withrange of motion.
(30:09):
We don't want'em to lose motion.
And, and they almost have this,um, you know, this, this, this
tightness period in the throwingprogram that so far is resolved
and every, you know, people aredoing great, but it's different,
right.
And, you know, I've, I've seenso many of these that I know
what to expect.
So when somebody's like, ah, Ijust.
Tight and they point like almostto like, like the proximal end
(30:30):
of their ligament.
And you're like, oh, ah, we'lljust, we'll, we'll ignore that.
right?
Chris (30:35):
Right.
Yes.
Mike (30:36):
But, but you know, for us, we're, I think we're gonna have
to start, uh, I think we have todo the same thing.
We have to evolve our thoughtsand our techniques as, as we see
new, new surgical improvementsfrom yourself.
So, um, that's, that.
That's awesome.
Um, what else, what elsebesides, uh, elbow, what else
are you.
Chris (30:51):
You know, one of the things that I think is
interesting and it we're gonnafind as a big contributor to,
um, injury risk and trends isthat we are starting to measure
more things.
That players can follow.
So, lemme lemme explain that.
So obviously pitch velocity hasbeen measured forever and
there's always been a metric ofsuccess for baseball players,
(31:14):
whether you're little league,high school, college pro, that's
something easy to look at.
You know, it translates tosuccess and everybody is sort of
obsessed with pitch velocity andthat has probably, um, driven
some of the entry trends thatwe've.
Now we're starting to do somesimilar things in other areas,
uh, of the sport.
(31:35):
So now any high school player orcollege player has access to, to
different labs and, uh,facilities they can go into and
they can get their exit velocityfor a hitter or they can get
their sprint speed and, and Ithink, and they can get spin
rates and, and so I.
These metrics are incrediblyhelpful for us in improving
performance and predictingperformance, but they're also
(31:57):
gonna start to give us values.
That players, coaches and other,and parents will chase.
And if they start to chase thosethings similar to how they've
chased pitch velocity, I thinkthat that will probably be
driving some injuries, uh, forsome of these athletes.
So I think that, and, and someof this will be other soft
tissue injuries that we see inhitters.
(32:18):
Some shoulder injuries.
We know, you know, there's a lotof force in the shoulder during
the swing.
A lot of rota rotationalcomponents to this.
So BLE type injuries, hipinjuries, low back injuries.
So I think we're gonna see allof those start to evolve as we
start to give hitters numbersthat they can chase, just like
pitchers that have been chasingvelocity, uh, for many years.
Mike (32:40):
And, and I, I, I couldn't agree more.
I would say the last two, threeyears I've seen an uptick again
of, of, you know, what we callbatter shoulder.
But it's, you know, y you know,there's, I guess, numerous ways
you could define that, but it's,um, you know, that that
posterior instability of, of theshoulder and, and.
You know, at, at, you know, inmy head I'm trying to figure
out, okay, what, why is thisticking up a little bit?
(33:01):
And we, we do see it inaggressive fielders, right?
So like middle in fielders,center field, you know, that
probably have a history ofdiving and subluxations and
stuff like that.
Um, but then you look at.
All of these kids, like you justcome to my facility any evening
at 5:00 PM and look at all thekids Then in the winter that are
(33:21):
just working on max intent, exitvelocity and launch angle and
just like grinding, grinding,grinding, uh, you know, on top
of, of, of fielding.
And, and it's, it's interestingto see.
So, um, have you noticed that atyour level?
I, I have started seeing it inour pro guys too.
Um, but how, how much of thisbatter shoulder.
(33:43):
Is, is this just in my hands?
Is this a New England thing orare you guys seeing that too?
Chris (33:48):
We're, we're seeing it, and honestly, it's, it's sort of
following similar experience toTommy John.
Uh, you know, we're, we'restarting, we, we've always known
about it in high level hittersand professional hitters, but
I'm, I'm seeing it in collegehitters and I'm seeing it in
high school hitters, and I'meven seeing it in some youth.
I've, I've had some 12, 13, 14year old, uh, kids enter their
shoulders while batting, and soit's definitely, it's starting
to, to trickle up and we'restarting to see more.
Mike (34:11):
That's, that's, I, um, I'm glad you brought that up
because, you know, we, we alwaystalk about pitching injuries,
right.
And I feel like the positionplayers don't get enough.
But, um, you know, I, I'mdefinitely seeing batter
shoulders.
Uh, uh, what, what else inposition players, you know, I, I
know the data shows, you know,hamstrings, obliques, huge.
Um, are you seeing any trends inthat?
Are we getting better athamstrings?
Chris (34:33):
Yeah, I think so.
It's starting to look like it,so we're actually looking up the
MLB data again, uh, just to seehow it's going.
But it, it seems like we'restarting to do that, you know,
especially at the, at the higherlevels in the, in the major
league levels.
Interestingly enough, if you.
If you look back at some of theolder data, the, the most
common, uh, position forhamstring injury was pitcher and
the most common mechanism wassprinting to first base.
(34:56):
And so you gotta wonder, youknow, going to universal DH may
help that, honestly.
Um, so that, that may, you know,cause our hamstring numbers to
go down.
But I think people are gettingtuned into it, whether it's
doing different.
Um, eccentrics or Nordichamstring exercises are more
sprinting, timing, uh, timing,gauge jumping, those type of
things.
People are getting clued intoit.
And, and honestly, I think thehamstring is sort of a great
(35:17):
success story of whatepidemiologic research can do
for you.
You identify, Hey, this is acommon problem.
In fact, it's the number oneproblem.
Um, and it's not catastrophic.
They're usually not seasonending, but still, and these
guys are missing three to fourweeks on average for these types
of injuries.
And there's a lot of'em.
Let's see if we can fix it.
And then there are actualinterventions you can take to
try to improve hamstringplasticity and string and
(35:38):
explosiveness and, and I, and Ithink it actually is making a
difference.
So I think that's one of thesuccess stories, uh, that, that
we're having.
And now I think we're gonna seethe same thing in other areas.
You know, we know that obliqueinjur.
Core abdominal abdominal muscleinjury.
So sort of the sports hernia,the abductor, the rectus, that
whole area.
Um, we're, we're seeing thatvery commonly.
(35:59):
So I think those are probablygoing to be the next area that
we're gonna really have to tryto intervene on and, and reduce
injury numbers for.
Mike (36:05):
And call me crazy.
Same thing as bad or shoulders.
It's, it's probably because ofthe increased volume and
intensity of swinging that, youknow, we're getting in these
sport hernia type likesituations in low back and
spies.
I mean, we're, we're, you know,we're seeing the, the kids with
the stress.
Reactions.
It's, it's crazy how much we'reseeing these things nowadays.
So, um, you know, uh, superinteresting.
Um, all right.
(36:26):
Random question about this then.
So hamstrings, obviously we'reseeing ticking up a little bit.
You still take hamstring graftfor Tommy John's, or, or have
you started to, uh, you know, isthat, do you, do you care?
Is that, is that something thatcrossed your mind?
Do you try to go Polaris more ordoes that impact your decision?
Chris (36:41):
That's a, that's a great question.
I do my go-to graft, so I, Idefinitely prefer autograft over
allograft for, for UCL surgery.
So always, always, always, ifpossible, use the patient's own
graft, uh, just because there'sbetter handling properties, more
biologically active, um,improved healing, all of those
sort of things.
So for me, the Paul Marris isstill the go-to graft and the
(37:05):
vast majority of players have aPaul Mar.
Um, for that 10 to 15% thatdon't, then I will go to
hamstring and typically thegracilis, which is the smallest
of the hamstring tendons,there's some debate whether or
not you should use the landingleg or push leg, and we've tried
to study it.
Don't really, you know, have,have a great answer.
I tend to use the landing legrather than the push off leg.
(37:27):
But, um, we don't have any gooddata to support that.
So Paul Meis is still a graft ofchoice for 90%, uh, but then ham
hamstring for the rest.
The thing that's interestingthough is that oftentimes
players are now coming in with avery strong bias to what they
want.
So they may say, wait, I knowyou did this guy's surgery and
used a hamstring, and he'sthrowing.
(37:48):
I want, I want to use myhamstring.
And then you gotta sort of say,all right, let's back this up a
little bit.
Let's unpack and talk aboutthat.
Um, but in reality, if they havesuch a strong bias, you know,
towards something, it can beoften hard to overcome.
So I am finding that more sothan ever in the past, players
actually have a bias towardswhat they want to use, which is
important.
(38:08):
You know, you wanna inform'em,ultimate's, everybody though,
we, we've gotta, um, do do whatthey want, uh, but try to give
'em all the information theyneed to make those decision.
Mike (38:17):
That's funny.
Uh, y y you know, we did thesame thing with hamstrings and,
and kind of our subset ofpeople, and I would say with the
pitchers, I, I feel like we get.
Much, you know, lead leg istrail leg, hamstring injuries,
to be honest.
And, you know, that kind of,that, that impressed me a little
bit too.
I thought there would be more ofa pattern, but it, it, it seems
like they injure them bothfairly frequently.
Um, and I wonder again, if thenext evolution in baseball
(38:40):
pitching hamstrings here is, youknow, all the biomechanical
people, the pitching coaches,everybody's talking about lead
leg block.
Everybody's talking about this.
And, you know, I, for, for usfrom the medical side, we've, we
know what.
Lead leg block is, and how it'sa b biomechanical conclusion
almost, right?
But we, we literally now havekids like jamming their knee
into hyperextension, trying to,trying to work on lead leg block
(39:03):
instead of just getting theirforce of momentum over their
front side.
But, um, I, I wonder if that'sgonna be, you know, one of those
next things with, with thepitchers is the hamstrings on
the, on their front side fromjust worrying too much about the
wrong.
Chris (39:15):
Yeah, I think, I think it's a great point and, and you
bring up a, an interestingconcept here, Mike, and I think,
you know, we've seen howobsessed people have come become
with velocity because it's agreat predictor of performance
or it correlates withperformance.
And I've always wondered, isthere a way we can do the same
thing for sound mechanics?
So can we have some sort ofnumerical score or um, ability
(39:37):
to grade or judge soundmechanics.
That will reduce injury risk.
And is there a way that we canmake that measurable and
appealing to our young athletes?
You know, is there, is there away we can start getting them
to, they're always gonna chasevelocity.
We can't prevent that and that'sokay.
But can we also find some waysto get them to become obsessed
with and start chasing.
(39:59):
Sound mechanics, good strength,and, you know, good injury
prevention principles, that'shard.
You know, it's like teachingkids to eat vegetables.
They don't wanna do it.
It's gonna be tough.
You gotta find a way to make itappealing.
But I think that that issomething that we need to be
doing as a, as a, um,professional group.
Mike (40:18):
Yeah.
And, and it's funny though, you,you brought up the, the
perceptions here, and I was justlooking at this in a slide, but
a study from cross last year in,in 2022 that talked about
weighted balls and, um, uh,what, what was it?
Uh, 86% of of people responding.
Thought that weighted ballswould increase their velocity,
and 85% of them thought theywould increase their injury
(40:42):
risk, but they, they did itanyway.
Chris (40:46):
Right.
And, and we, we have torecognize that as medical
providers, you know, we, we tendto be very, um, injury risk
averse.
Much more so than our playersare.
And that's okay because we'reoffering a unique perspective
that they don't have.
But we also have to recognizethat if, if we just say, Hey, do
you know these things are gonnaincrease?
You know, such and such is gonnaincrease your risk of injury?
(41:07):
They'll probably say, yeah, Idon't care.
I'm gonna do it anyway.
And so we, we have to beprepared to understand that,
have that conversation and, andmeet'em in the middle and also
recognize that.
You know, some, except we allhave to accept some risk of
injury or we wouldn't be playingsports at all.
And so we just have to sort ofwork through what our threshold
is for injury risk and put and,and kind of marry that to the
(41:29):
injury risk threshold of theplayer and try to get on the
same page and help them and knowthat, you know, it's never gonna
be exactly what we want.
And it's never, maybe neverfully what they want either, but
we gotta try to work together tofind that that happy medium, it
gives them the balance ofoptimal performance and minimal
injury risk.
Mike (41:47):
Yeah, and I think I struggled with that a little bit
earlier in my career where.
you know, that I think thatwould bother me a little bit
more.
But man, I, I'm so much morehumble about that whole
experience with the players now,where I was like, look, I, I'm
just here to educate you andthen you hired me to help you.
Right?
That's how I kind of think ofyou, even though we're medical
right?
You, I, I'm here to help you.
I, I'm not gonna also adviseyou.
(42:08):
But I'm also gonna help you.
Right?
And that's the whole goal.
And, and even within baseball,sometimes sport science gets
that, that, you know, bad rapsometimes.
Um, but it's, it's aboutmaximizing your play between
those white lines and notlimiting it.
Right?
We're not trying to limit you,we're trying to get you as
prepared as we can and get yourcapacity as high as we can.
Um, and I think as a medicalcommunity, we have to embrace
(42:31):
that more so that way we getbetter buy-in from, from
everybody.
Right.
And, um, heck, I've, I'vedefinitely.
I'm probably labeled on Twitteras like a anti weighted ball
kind of guy.
And I'm not my, all my athleteslike use weighted balls to, in
extent, but we do it as, uh,intelligently as we can.
Um, you know, just because ourdata showed some negativity
(42:52):
doesn't mean that there isn't away we can apply it.
We just have to dose itcorrectly.
And that's just a concept thatmost people don't.
Chris (42:59):
Mm-hmm.
And, and I think it's true and,and our tolerance for risk as
medical providers is relativelylow, but we have to recognize
that for some of our players,you know, you, you've.
38 year old veteran who's stillwanting to play and is
struggling and they're saying,listen, if I don't pick up three
miles an hour, I've gottaretire.
So, and I say, I may say, Hey,this is really high risk for
(43:22):
you.
And they may say, if I don't doit, I'm done.
You know, my chance of playingare 0% if I don't do it.
So you're telling me, yeah, is ahigh risk of injury, but this is
the only way I can keep mycareer going.
Okay.
We have to understand that andbe okay with this.
All right, we're gonna do it.
Let's talk about how we can doit the right way, the smart way,
and try to try to get you betterwithout getting you hurt.
So we, we, that is often verydifficult for us to do, but
(43:43):
ultimately we have to recognizewe're here for them.
We're not here for ourselves.
We're, we're here for them.
And so we have to know whattheir.
Mike (43:51):
That's, that's awesome.
That's a great way of thinkingof it.
And yeah, we could, we couldtalk for hours.
This is amazing.
Um, I know you gotta get, uh,probably you're reconstructing
some ucls this afternoon at somepoint, so, um, uh, we, we could
keep going for hours.
Uh, before I let you go though,uh, we'd like to end with a
quick high five.
Where Five quick questions, fivequick answers.
(44:11):
Um, I, I love hearing this,especially from such well
established people likeyourself, just to show everybody
that you still have a growthmindset and all this great
stuff.
But, um, five quick questions.
First one is, what are youcurrently working on for your
own professional development?
Like your, what are you reading?
What are you learning for
Chris (44:29):
yeah.
Great question.
Yeah, so for me, actually, everyJan, I have a list of January
books that I reread everyJanuary.
So I'm, I'm a big reader, right?
And right now on the list, I'm,I'm going back through Marcus
Aurelius's, uh, meditation.
It's one of my favorite, I thinkI read it four or five times,
but I reread it every January.
It's, uh, A lot of wisdom.
Every time I reread it, I pickup new, new things.
Mike (44:50):
Is that, is that,
Chris (44:51):
I highly recommend it.
Mike (44:53):
I was gonna say, is that, is that your, is that your
number one book recommendationfor somebody that's, that's,
that's trying to work onself-improvement?
Chris (44:59):
No, that wouldn't be my number one.
Um, that, that one is usuallyit.
It's better sort of once you're,uh, partially down the trail and
you've sort of already done alittle soul search and you have
a little bit of an idea.
Um, cause it takes a little bitto, to put that one into
practical use.
Um, but in terms of like bestbook recommendations, a couple,
you know, you mentioned a growthmindset.
I'm a, I'm a huge Carol Dweckfan, uh, growth mindset.
(45:22):
I think Atomic Habits, uh, is,is a fantastic one for
developing systems andprocesses, uh, grit.
Fantastic.
Uh, peak and Owned by AndersErickson.
All of those are good.
I think it is sort ofestablishing yourself on a
pathway towards expertperformance.
Mike (45:37):
That's awesome.
Great stuff.
Uh, what's one thing that you'verecently changed your mind?
Chris (45:43):
Yeah, I'd, I'd say, um, I've always historically been a
very, very much a goal-orientedperson.
Um, but I've actually sort ofabandoned that in recent years.
Uh, and I really think thatsystems and processes, Trump
goals.
Um, every time.
Every time.
And so I, I have.
(46:03):
Essentially eliminated almostall goals, uh, from my life.
And I've worked to developsystems and processes that are
gonna help me get to the place Iwant to be and be the person I
wanna be.
So, uh, systems and processesover goals every, every day of
the week for me.
Mike (46:19):
That's awesome and I'm maniacal about that as well.
You can ask everybody I workwith, right?
We have.
So many, uh, uh, standardoperating procedures for
everything written up.
Uh, once it starts blending intoyour personal life though, and
you have a system for likemaking coffee in the morning,
that's when, when your wifestarts to get, uh, agitated with
you, but but, uh, but yeah,
Chris (46:39):
my wife could definitely, uh, could definitely share that
frustration.
Yeah,
Mike (46:43):
Once you, once you start thinking systems, you can't
think anything else.
Right?
Even you go to a restaurant andyou're like, the, the, all the
systems are all broken here.
I can't, I can't
Chris (46:51):
This is how they should be doing this.
Yeah.
This, this.
Mike (46:54):
That's why, that's why you're a leader.
Um, all right, next question.
What, what's your favorite pieceof advice that you give
residents?
Chris (47:00):
Yeah.
So my, my key, I, I try to makeit as simple as possible, and I
tell'em, always stay humble,hungry.
Those are the two.
If you, if you needed twoadjectives to describe yourself,
humble and hungry.
And I think that's true of anyyoung, professional or older,
professional, uh, in the world.
If, if you're humble, you're aperson who's got, An open mind,
you're responsive to criticism.
You've got a growth mindset.
(47:22):
You're gonna be a better teamplayer.
People are gonna enjoy beingaround you, and your ceiling is
much higher.
And obviously, if you're hungry,you're gonna, you're gonna have
the energy, you're gonna bemotivated, you're gonna do the
things you need to do, you'regonna be doing, you're gonna do
the stuff that others are notwilling to do.
You're gonna do the hard work,you're gonna have the high
tolerance for boredom.
And I, and I think that'ssomething for younger people to
(47:43):
think about, especially ifyou're trying to get into
baseball.
Oftentimes you think you'regonna come in and it's gonna be
glitzy and, and, and it's gonnabe a lot of glamor.
And in reality it's not.
And, and nothing in life is,and, and I think it's the people
who have the high tolerance forboredom.
Are the ones that can beextremely successful.
So can you keep doing the rightthings every single day, day in,
day out, over and over and overand over and over again, and
(48:06):
stick with it.
Um, those are the people thatare gonna be successful.
And I, I think that, so stayinghungry, humble, uh, would be my
two pieces of advice for any,any young professional or
somebody that's been at it for awhile and needs to freshen
things up a little bit.
Mike (48:19):
I like.
I like it.
And then follow up with that me.
I think you're, you're in a goodspot right
Chris (48:24):
Exactly.
Exactly.
Yeah.
Yeah.
Mike (48:26):
Alright.
What's coming up next for you?
Chris (48:29):
Yeah, so spring training's right around the
corner, so always excited aboutthat.
Um, so we got that coming up.
And then also a couple newthings in the, in the research
world that I'm pretty excitedabout.
We're, we're gonna start, youknow, people have seen, uh,
marker based motion capture ofthe pitching motion.
Uh, we're starting some studiesdoing it for the baseball swing.
We, we talked about that earlierwith the obsession with ex exit
velocity things.
(48:49):
So we need to figure out moreabout the, the forces that are
happening throughout the body,through the swing.
Got that coming up.
And then another thing that I'mreally interested in, and we're
starting to, to use in some ofour research is using different
machine learning and artificialintelligence approaches to try
to sort out some of these issuesaround risk prediction, uh, risk
mitigation for injuries andthose types of things.
(49:11):
So those are the few of thethings coming up that I'm, I'm
really excited about.
Mike (49:14):
That's awesome.
I, I'm really looking forward tolearning from that, from you.
So.
Awesome.
Um, where can people learn moreabout you obviously go to
PubMed.
Type in your name and, andthat'll give you a, a few months
of reading.
But, uh, where, where else is,is there a place that they can
find you if, if they wanna senda patient to you or anything?
Where, where can people findmore about you online?
Chris (49:34):
Yeah, a couple spots.
Um, so yeah, all, all ourresearch is on, uh, PubMed.
Uh, our website is, uh, sportsmedicine dot mayo clinic.org.
So if you wanna just go to theMayo Clinic Sports Medicine, uh,
Google that you'll find it, thatsort of tells you all about our
clinic and how to get patientsin and what we have to offer,
those sort of things, if youwanna do that and.
I'm also moderately active onTwitter, trying to share
baseball injury research andsurgical techniques and things
(49:57):
like that.
So at Chris Camp md, uh, is theTwitter handle.
So either of those spots willwork.
Mike (50:02):
Yeah, and I will say you are a great Twitter follow, um,
cuz you're.
Posting really good stuff andyou're active.
Right.
And it's, it's, um, you know, II think sometimes people, uh,
don't, uh, appreciate thatenough, right?
To, to be able to interact withsomebody like yourself on
Twitter is, is priceless.
So, uh, so take advantage andfollow'em and, and ask questions
and, um, it's, it's a greatexperience.
(50:23):
So, um, well, thank you so muchDr.
Camp.
That was amazing.
Um, good luck this season.
I, I hope, hope to, to see you,uh, at some point during the
year.
But thanks so much for coming onthe show and giving so much of
your perspective.
Is amazing.
Chris (50:37):
You got it, Mike.
Really appreciate it.
I, I enjoyed it.
As always, enjoy listening toyour podcast, so it's an honor
to be a part of it.
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