Return to Sport with Pete Draovitch - Episode 45

Return to sport has been a hot topic in sports medicine recently. Studies continue to show that reinjury rates can be high, and athletes do not always return to previous levels of performance.

In this episode, I talk with Pete Draovitch of the Jacksonville Jaguars about his approach to return to sport, which he has published and calls the Return to Sport Clearance Continuum.

Full show notes: https://mikereinold.com/return-to-sport-with-pete-draovitch

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Transcript

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On this episode of the sports physical therapy podcast, I'm joined by Pete Dre of itch. Pete is currently a performance specialist, physical therapist and athletic trainer for the Jacksonville Jaguars. After spending many years working in so many different prestigious positions within baseball, hockey, golf in that HSS. And this episode, we're going to talk about his framework for returning athletes back to sport. Welcome to the Sports Physical Therapy Podcast. I'm your host, Mike Reinold from MikeReinold. com. Hey Pete, thanks so much for joining us on the podcast today. How's everything going? It's great, Mike. Thanks for having me. Sorry. I couldn't, we tried to get together a couple of months ago. It didn't work out. So, uh, but this, this is a good day to do it. And I'm glad I, I could be a guest on, on your podcast because of all the contributions you've made to the field and, uh, all the great work you guys do up at champion. Uh, I appreciate it and, um, yeah, it's not easy to try to find time to do stuff like this. So, you know, thank you for that. Who would have thought it would have been easier for us to find some time in season than it was off season, but sometimes that's how it is in pro sports, right? You're right. You're right. Um, well, Pete, before we get into it, I know we got a good episode. There's a lot of great stuff we want to talk about. Uh, you've really had a heck of a career. I think something that, you know, most people would look up to and say, that's what I want to do when I'm. You know, when I make it in this career, and I feel like you've done that like three, four or five times now at this point, you keep doing things that some people would be satisfied with as the peak of their career. That's just one of the many things that you've done. So why don't we start just tell me a little bit about your background, like how you got to where you are today. And I know you've got such a diverse background. You know, baseball and golf and, you know, a huge position at HSS for forever. And now all the way with the Jacksonville Jaguars. Um, why don't you walk us through a little bit about like how you got here, you know, through your career and make sure the readers understand. Okay. Basically, uh, I started out as a grad assistant football coach at university of Delaware. With Toby Raymond and, uh, and as you know, if you're a grad assistant, a lot of times you're a year older than the kids that you're supposed to be the grad assistant for. So whenever, so whenever anything happened on a Saturday night, guess who got that call from right? You. About after the 10th, one of those, I just said, you know, there's got to be another way to do this. So the athletic trainer at, uh, Delaware Keith handling told me, he said, well, you could get involved as an athletic trainer. So I'd taped and all at Gettysburg college, what left the bizer a long time ago. And, uh, and so I took anatomy class. I, my memory was pretty good. And then it just happened that I ended up, uh, finishing up. An athletic training degree at Delaware and then then from there I took a job at a high school. Out in Western Pennsylvania, uh, got a chance to go to Lehigh, uh, with football and wrestling, and then, uh, decided that I was working three times as hard as a PT, and making one third the amount of money. So I went to PT school and ended up... I just got married. My wife, I said, where do you want to live? Do you want to live down in North Carolina? Do you want to live in St. Louis or do you want to live in Miami? So we ended up going to Miami and, and then that's where everything started from the sports standpoint. Now you've got channels you got to go through when you're a kid, you got this internship, you got to meet before you do this. Back then, you just had to show that you were willing to learn, you worked hard and you did a good job for the people that you were working for. So it's like down in Miami. Kevin O'Neill and Ryan Vermillion and Bill Farran and then we were, I was there in the heyday. So anybody that was part of Jimmy Johnson's Staff even worse. Grad assistant. People wanted to know what was going on there because it was it was unique with the amount of athletes we had. And, um, and then from there, I ended up leaving football, got involved up in West Palm Beach. With a doc named Frank Cooke, who was served as a doc for Montreal expos at the time, St. Louis Cardinals end up coming in and making that their spring training site. So I knew some people from the golf tour, Paul Hostenthal, he introduces me to Barry Weinberg, and then I helped them out for five years, end up going to UPMC and working with Jim Bradley and Dr. Fu. Joe Maroon for, uh, five years up there, and I met Brian Kelly, who was a fellow for Mark Philippon, who I worked with in Florida and who took me up to Pittsburgh. So, from there, I ended up at HSS, ended up working with the New York Rangers for six of the ten years I was up there, and then one day, a guy from down in Jacksonville, Coach Coughlin, Had been the coach of the Giants and during the strike season in the NFL, they didn't have a place to send their players because they couldn't come to the facility. So I ended up seeing a lot of players from the Giants and the Jets. And, uh, the guy called up from, uh, down here in Miami or in Jacksonville named Tom Masalinski. He was their strength coach and said, Hey, I'm looking for a young kid. So I gave him three names and it just happened to be about, I don't know, maybe. 10, 15 degrees below zero. I said, the next time you call up here, if you're, you're going to offer a job, I said, I'm going to throw my name in the hat and I was like, Hey, I'm 62 now. So I was 58 years old. And then they called me back and said, Hey, would you want to come down for an interview? I said, I was just kidding. She wants to move back to Florida. So that, that's what happened. And then they brought me on to be sort of like a hybrid between the training room, the strength room, and now trying to help interpret the sports science from a, from a rehab and a progression standpoint. So, so it's just I was always, I always tell my daughter, life's about chances and choices. And I've always changed about every seven to 10 years. And I've always tried to surround myself with good people like HSS. I mean, you look at their, Dr. Olchek, Riley Williams, Dr. Warren, Aynsworth Allen, Lisa Callahan, Josh Steins. I mean, I was seeing people that were seeing patients that were just, they were the premier surgeons to go to. So, it just always, uh, I've always tried to do that. And then mentors like you guys, like, to be able to call you, to call, call Kevin Wilk, call Bob Mangine, Russ Payne. Uh, it's, it's just. It's sort of crazy how it all has worked out, but I'm still feel young. I still got energy. And, uh, I like being around young people as you, as you know, being around young people, cause they keep you going. So they call me grandpa. They call me every other thing, but I'm still good for one. I see. I mean, what, what an amazing story and progression. And, you know, if I were to take one thing out of that, it's, it's all about connections, right? And it's all about not burning bridges. It's, it's about having good relationships with people and, and things will grow. And, and, you know, I, I, I try to advise some of the young professionals on that is that. Everybody that you're working with right now, um, you know, you have an opportunity to reconnect again in the future. So, you know, just, just be careful and try to nourish everything you can and really take advantage. And man, I can't think of anybody that's done a better job of that than you. It is. It's being inclusive. Don't in a book, uh, uh, by the, uh, all black, uh, rugby team, uh, they, they have a book out. It's, it's a, it's a, it's a quick read. And, uh, and one of their rules in it is don't be a dickhead, right? And I'll just tell you this, you'll think of how many people you met early in your career that 10 years later, 15 years later, it circles back. And now you've got a relationship that was formed then, but now it becomes a stronger bond and it's a benefit to both of you. I like it. That's, that's a great phrase. I don't know if I could make a social media clip out of that. I don't know if that would be the best thing to do, but I, I think, I think that's a, that's a, that's a great, uh, phrase to use and, and not enough people respect that. Right. And hopefully they can look at somebody like yourself and your career and see how the fruits of your relationship making continue to just continue to. just build success with you is it's impressive. So, um, tell everybody a little bit about your role with the Jaguars. Cause I know a lot of people want to get in the NFL. A lot of people love football. You know, I, I myself, I don't even know what your day to day is like. It's, it's, you know, the, between the different sports, it's so different, but like, what's it like in your role with the Jaguars in the NFL? Well, for me, it's I'm hired is P. T. A. T. C. for the Jaguars. Uh, and then have a little bit more role in the sports performance side if you want to call it that. But I'll go between rooms. My main thing is I see people Uh, as as a clinician. However, I'll I'll help sit down and look and say, Okay, we got this person going on with this problem. I need them to be correctives and then to flip them off my plate and get them into performance side or let's monitor them from a sports science side. And then at the end of the day, let's interpret that or the end of the week. Let's interpret it and see what we got to change so that that person doesn't break down again this year. So We try and meet once a week as a seamless group of people between rehab, performance, nutrition, and sports science, and look at everybody collectively so that everybody has a collective plan and everybody knows. What's on the same page and the and the colleagues I have here, Jeff Ferguson, he's been in the NFL. He's with Sam Fran for a number of years. He's the head trainer, but, uh, Robbie Hohenschell is the director of rehab, Chris Box, the director of sports science. And then the other athletic trainers with me, Raul Bermudez, Cassie Attell and Devin, uh, Witherspoon, they, they've all been, you know, you. I offer some things to them that they don't have, and they offer some things to me that I don't have. So, um, that's, that's what we try and do, and the focus is to be athlete centered. And put your, put your egos on the side. If you don't know something and somebody else knows something better about that, don't be afraid to flip that person onto that side and say, Hey, uh, you work, Robbie, you worked with, in the NBA, you're better at foot and ankle than I am. Would you mind taking a look at this for me? So, uh, I think Ferb does a good job of making sure that the ship keeps going in the right direction. That's amazing. And I think the question that most people listening to this are probably going to have about your role with the Jaguars is, is Trevor Lawrence's hair as beautiful in person as it is on TV? You should be doing head and shoulders commercial. I've been dying to ask you that question. So, uh, but no, it's nice to hear what that's like, because a lot of people don't understand what it's like to work in a high performance department with multidisciplinary collaboration. Right. And, and, you know, to be able to, to live and breathe that is. It's something really special. And I'm sure every day you go home and you're, you're probably grateful that you have an opportunity to collaborate versus having to be on an island by yourself. Right. For sure. Uh, I mean, the people that work in a clinic and they just, I don't know how you could do it where you're not learning constantly. Like I said, I mean, I change stuff up just like you have a long time, but some based on the evidence, some based on what I see. And again, if. If, if you go in and you're not challenged. All the time. Like I sit here, we sat here today looking. Okay, we have this person that has this problem. What could we be doing better? Our GM as a saying could be better. And right. It could be better. So even if you're good, there's that little bit that might just be the next. And you know, at this level. Hell, one little bit extra might make just the change you need to make the hugest difference. So we're always looking for that. This level of sport isn't for the people that aren't constantly thinking and are critical thinkers and, and really look at themselves first, as opposed to looking at all the other people. And right when you think you have everything figured out, the game changes, right? And just in even in my brief time in baseball, right? Over the course of the last, you know, three decades or so, there's very distinct phases of each of those decades, right? So the game keeps changing. If we don't evolve around what the unique needs and goals are of the players at that time, and we stick to what was happening 10 years ago, we're never going to get 1 percent better, right? For sure. And again, like you said, you, you've been at the forefront with the throwing athlete forever. And how many times have you changed your program in the past 10 years? Right. And, and unfortunately, unfortunately, it's because of the mistake that we made that we realized that it's not because of the success that you have. You, you, you, that's right. One person go, man, I shouldn't have done that. And, and, but it is, it's the truth. And that's how you get better, but well, I think that leads us into a nice little chat about one of your recent publications that you've had. Um, and it's called the return to sport clearance continuum. And I thought this was a really great article, but more importantly, I think it was a really nice framework to see. And, and this is what a master clinician does in my mind. This is what an expert in their field does is they have the experience to be able to come up with frameworks. Right. So return to sports is always going to be a hot topic. Like, like what made, what kind of made you say, Hey, it's time that I write this article. Like, like what led to development of this approach and what made you get this published? Well, I think if you look at it, there's so much, there's ad nauseam regarding whether it's a control chaos continuum, it's, it's, uh, Isokinetics, we're going to do this, this, and this. I just got tired of seeing people that were sending people back and not having any structure to what they were doing other than to say, okay, they have a five out of five muscle test. So, I mean, in any clinic, I did it more for people that didn't have access to the technology that we have, then I did it for, for us in general, because if you have, if you could to do a white balance test. And you could see how much a person does a wide balance test in the anterior direction or a front step down. I mean, just have a system that, that looks at the general, uh, breakdown of, of what a system should look like. So you got repair, what happens with the tissue? We, we don't look at tissue integrity enough. And in our level, sometimes you probably don't want to look at that because we know that an MRI that you take now it might look exactly the same three months down the road, even though clinically the person doesn't present like that. So, again, then there's rehab and recovery there's reconditioning there's performance. And then the big thing that I see is preseason and training camp the person, they, they quit. They put them back in training camp, and instead of having them have a load management issue, they have a rep count, they have something going on, and now the person gets irritated in training camp, and now it's four to six weeks before they're ready to go again. So, we wanted just there to be a structure to say, hey, if you, if you have. To bring people back. I don't care if it's high school college. There's a movement and core thing you should look at. You should look at strength and endurance. You got to be thinking of power because if that's a sport they play, you've got to have some type of sports specific conditioning. How do you watch load? I mean, kids have what kids have watches anymore. Even steps. How many steps did you take? That might tell you something. And then we know that, uh, just an outcome score of a self perceived outcome score in some of the literature shows that that might be almost as good as doing all of these metrics anyway. So, so that was, that was the purpose of it. And it wasn't, it wasn't anything that's new. It was just broken down a little differently. And we said, okay. Let's give everybody a chance to do it the right way, regardless of what level they're at. Well, and you built a framework, right? So, we talk about this a lot in some of the systems that we have and that we teach, but you taught the recipe, but you can tweak the ingredients a little bit based on who's in front of you, right? You don't have to do it exactly the way you do it, but if you follow the framework and Put your pieces of the puzzle into that, then you're going to have success because you follow the framework from start to finish that that's pretty neat. Well, well, again, I think I think it I think it is. I think it's common sense, but sometimes the progression is where people get confused. You know, some people I see they do great in the beginning, like using an analogy from from baseball. We got some really good starting pictures. We have some good middle relievers and we have some good closers, but all of those people have to depend on somebody else. What we're saying is be the starter, be the middle reliever and be the closer. If you just put it in a framework type of strategy. Right. And you said common sense. But that's common sense to you because you've been doing this for so long. I think a lot of people are going to appreciate the way you help them organize their thoughts. And I think that's going to be really impactful for people as they're going through this for the first time, right? You just take it for granted, Pete. Well, again, when you do it as long as we have, it's, it sort of does become, and again, sometimes you got to catch yourself to say, don't, you always got to feel like you're doing it for the first time, or because that's when you make your mistakes, you get mundane about looking at it, and then, then you realize, okay, this, This guy has a, uh, he had a tibial osteotomy as an antiverted hip. So I'm going to avoid that. But if you forget looking at some of those things, you end up making some mistakes. So again, you're right. Love it. Um, well, we know re injury rates in sports can be high and we often see players that don't return to their peak performance too. Why do you think that is? Like in your experience, what's been some of the reasons why people don't return to sport as effectively as they can? I think, uh, if you look at it, there's, there's probably three things in general that you're going to look at when you're returning somebody to sport. What can they produce force and do they ever rate of force development? What's What's their quality of movement? And then the third thing is their tissue integrity. If, if their tissue integrity is bad, and we've had people like that, that you do everything that you've done for everybody else. And then six months later, if it's not a hammy, it's a quad. If it's not a quad, it's a calf. So sometimes The tissue integrity is the limiting factor. Sometimes people, the limiting factor is their quality of motion. They have good strength, they have good mobility, but their, but their software is really bad and no matter how much you work on it, it still doesn't get there. Uh, and then, and then the third thing is, can you, to play in sports, can you produce force and can you produce it fast so that you shift the force velocity curve to the right? So. In my opinion, it could be any one of those, whether you're looking at force and force velocity and load management. What's your quality of movement? Great cook. Great cook. Put that together a long time ago, and people still are looking at that still don't have all the answers. Now we got motion capture systems. We have a Dory motion capture here and. And, and this year it'll be one thing that we find, and next year it'll be the next thing that we find. But, to me, structure's always influenced function, function always has influenced, influenced performance. So, again, those three things are the things that I try and spend time on, and then try and identify what their tissue's like. We got athletes that are really twitchy, when I get them, I, like, you don't get many of them that you put their tissue up and it comes right back down. Right. So you, so you got those people that are elastic, you got those people that are more powerful, you see them jump over hurdles and some of them look like kangaroos and then other ones, they go up over the hurdle powerfully, they land, they absorb it, and then they do it again. So I'd say those are the three things that you try to look at. And sometimes you're going to get, you're hopefully guessing right a lot, but sometimes you, you, You're, you're gonna miss something, whether it's structure, function, movement, tissue integrity, uh, what's his name, said a, a great quote, uh, in it, or his underlying message in a paper by Arnosky in 2008, I read it, and it made me change a lot of things, and that the underlying message was underloading during rehab meant to overloading during performance, and so sometimes people come into the, Into the performance side and they get blamed for the blame is put on the performance side when really That people in the rehab didn't do their job and it led to the performance getting the blame for it. So I've always been cautious of that to make sure I under load. So I'm going to make sure I have isometrics. I'm going to make sure I have eccentrics. I'm going to make sure that I have some type of concentric work. I'm going to have... There's some velocity based training. If I see that the weight room has their program set up, that they're doing a power block or a hypertrophy block that week, I'm going to take the parts that they're not getting, and I'm going to put it on my side. So that their rehab component is going to be, it may be more based on strength endurance. So that that person doesn't miss that part of the program that could actually make them fail where they lose capacity. So, uh, again, it's being in it a while that you get to start thinking like this, but, uh, but the Arnosky article made me rethink a lot of stuff, probably in 2005 to 2010. That's another great quote. I like it. This is going to be an episode of quotes. I think it's, I think that's awesome. But, um, in your framework, you outline five phases, right? Of, of your return to sport clearance continuum. Um, I thought it was always great, you know, to, to break things down. I think that really helps people learn the, the subject matter a little bit better, but can you explain to people on the podcast and I'm going to put a link in the show notes to the article so people can read this, but can you walk them through just briefly what the five phases are and maybe what the important characteristics of each phase are. So they have a general understanding of, you know, from start to finish what it looks like to return to sport. So if you get a person in and they get injured, what's the first thing that has to happen? Let the body do some of the work for you. So you got to repair phase, right? So. We know about repair repair phases that the first 21 days is when the tissue is going to be that you could mold it. But if I got a grade one hamstring, maybe after two days, I'm going to start doing some of the asking stuff. If I got a grade two, I might take five days because it takes a little bit longer for that to get out of there. But I want to get rid of the swelling. Dr. Fu in Pittsburgh said a great saying. He says, Swelling is the speedometer of rehab. Because if you got swelling, it means something. Your mechanics are wrong. You got some kind of mechanical problem going on. But again, to me, that's the phase that I'm really going to be cautious. I'm getting rid of as much of that swelling as I can. I'll get my motion going. And then the rehab and recovery phase is what we traditionally view as your clinical side. The clinical side to me, the rehab part, is when you're going to start All of the things that you need, you got your coordinate, you got your, your balance, your strength, your range of motion, your mobility work. Uh, and the recovery part is the part I put on the athlete when, when I was with the Rangers, with Jim Ramsey and, uh, uh, Reg Grant, uh, Adam Virgil, what we, one of the things that we did is anybody that got drafted that year, we gave them, uh, a, uh, ice device. We gave them a more pro and what was a pair of Norman Tech boots and they have all the time in the world to recover at home. So we wanted to make sure that their recovery was going to be good. So that's what I mean by that. You share that with the athlete because there's got to be home exercises. We do home exercises for these guys. I'll tell him I need two sets of 10 tonight, two sets of 15 just to keep things going. Reconditioning phase. I say the reconditioning phase is, uh, to quote Bill Knowles, he said the reconditioning phase is when the focus changes from the injury to the athlete and Bill's been doing it a long time. Uh, and that's where you start to say, okay, I'm going to start leaking performance into this side of the equation so that we start thinking about conditioning, even though it might be six weeks or eight weeks before they play. We're thinking about loading them under a bar. We're thinking about incorporating. Uh, the next progression from rehab exercises, what's the next progression or regression for the performance side? And then from performance that might last three months. Um, where we're looking at, uh, two, six week cycles, three, four week cycles, whatever it might be. And then the last part for a person that you're bringing back from a post surgical or a long standing injury is making sure you're doing load management, rep counting during camp so they don't swell up or they get irritated during that time. So repair phase for me, it can last up to 21 days based on the biology of tissue. Rehab and recovery. I want that four to six weeks and then I'm getting them into reconditioning no later than four to six weeks and then and these all overlap, they might be doing something for the upper body when their lower bodies hurt that they're in performance side already. So, It's a, it's a fluid type of thing, uh, but repair zero to 21 days, usually three to five rehab and recovery, four to six weeks, reconditioning, probably four to six weeks performance at six to 12, uh, eight to 12 week cycle, and then preseason camp and get ready for that until you get to the season. So you make it through. Amazing. And I can see how that framework is super helpful for like a long term management, but walk me through something quick, like a lower extremity injury with that, where let's say like a grade one or a grade two hamstring, which I'm sure you deal with, uh, probably weekly, right? Like what, what, what, like how does that overlap and how quickly does that progress on, on something like a grade one or two hamstring? So if we look at a grade one, 10 to 14 days, grade two, we're going to change that maybe three to four weeks. Now, if they get a PRP injection or they get some other type of stem cell or something in there, that three to four weeks might be four to six, that one to two weeks might be 10 to 14 days. Might take up to three weeks, but repair there, we're going to start that in that one to two days, boom, if you're an acute and you're in season one to two days, and you're going to rehab and, and, uh, recovery. So that might take, uh, might take that five to seven days, uh, reconditioning. That's going to be quick because I need you running. If you're going to do a hamstring, nothing can, nothing can simulate. Anything force wise on a hamstring other than fast running. So if I have a grade two hamstring, I might have a two week buildup to get them to max velocity and, and high speed yardage. So if we look at that, we're looking at max velocity, high speed yardage, and we might be looking at player load based on, on catapult data, but to me, we're going to just. Speed that up so that repairs one to two days rehab recovery grade two is going to be up to the seven day mark. Reconditioning is going to, if that's a week and then performance is two weeks and they're ready to go. And that's if they don't have any orthobiologics involved. And then from there. Uh, we probably slow that down a little bit because PRP, the way we do it, they give them two days off, no heat, no, uh, cold, uh, no real motion. We just hit them with some, some modalities, get them out, and then we start them. It's pretty amazing too, like if you got to do two PRPs back to back a week apart, uh, uh, by the second one they get the first day after you get them, like, it's really good. So again, it depends where it's at, what part of the hamstring it is in, is it too big to do a PRP? Um, so, uh, but that's, that's how I break it down for something like a hamstring. That's great. It's really making me want to draft more Jaguars from my fantasy team next year because I know they're going to be in good hands and they're going to get back on the field as soon as they can. I stay away from any betting from what's happening. You probably could actually have to, I hope at least. So, but we don't even talk about it. So what's the future look like with technology in this? Like, so how do you reconcile some of like the new data and tech based things? And how do you put that together at the pro sport level? Cause it's probably coming to everybody soon. There's, there's so many ways we can do this, but tell me a little bit about how you use technology to do all this stuff too. Well, you've got now you've got so many things that are out there. Uh, you've got, if, if you're doing it week, weekly measurements of power, you, you got force plate jumping. You, uh, if you got, if you got linemen, you might do something a little bit different instead of the jumps all the time, like a half pull. Uh, way to measure that isometrically. Um, the other thing is 10 80s where you got 10 80 sprint and you're looking at forces. You're looking at differences between right and left. You've got things that measure power velocity based training. So there's tons of things out there like that, uh, that help measure those things. You've got catapult with GPS and accelerometers, uh, that measure total distance, high speed yardage, uh, player load, And they put them all into algorithms, of course, and metrics that we will take and we'll say, okay, this person jumped off the force plate, they had a 22 percent deficit from the right side to the left side, what are we going to do to correct that? And usually you don't jump at the gun when you see these deficits, because the person's probably been doing that for a long time. So you look at trends more up at this level. Where, uh, you're saying, okay, they've gone from 22 percent to 25 percent to 28%. Okay. Over a three week period. Let's say what's going on is, do they have something going on? Then you eventually talk to the player and they'll say, yeah. And I, I, I've been having this, uh, calf problem or this ankle problem. And then it, the, the, the results 10 80 sprint. That measures force that measures speed, uh, and be able to, um, force more than anything where you could see the difference between the right and the left side person coming back from some soft tissue. Soft tissue is the Holy Grail in the NFL, for the most part, just like your shoulder stuff is in baseball. That, I mean that. the calf, the quad, the hamstring, the adductor. Uh, and the NFL has done a really good job of collecting all the data between teams to come to some of the conclusions they have. So we pay a lot of attention to it and we spent a lot of time on recovery for That's awesome. So again, I'm going to put the the link to this article in the show notes So you can kind of read Pete's continuum and really learn from it I think it's something that everybody should read it should be mandatory in curriculums in my mind and something that everybody follows but Pete before we let you go I think this is something that most people probably ask you and you get this a lot here but I know a lot of the listeners of this podcast not only do they want to get into pro sports, but A lot of them want to get specifically into the NFL. What sort of advice do you have for students or early career professionals that want to break into the NFL and maybe get a job in that realm? What would you tell them? Well, if you want to get into, into football and you're going to get in the NFL, you got to do internships. So there's a summer, a summer position that's available. Most teams hire four to six people for that. And then you've got a seasonal. So usually the progression is summer to seasonal. Uh, You apply, uh, you apply for that at, uh, the PFATS professional football athletic trainer society, where they've made it easy that you could apply to all the teams that way. Uh, so it's PFATS. com or PFATS. org. Uh, and then you'll put your name in and then you'll get contacted by teams. Most teams will interview people. And like I said, you go from a summer position where you start during camp and then you end. Usually the end of August, uh, uh, for that, that internship, the seasonal, you start Usually be at the end of the following season and you go until the season's over, uh, maybe a little bit past that. It's usually, we have a year commitment, so they'll usually go from April until April. Um, so, but if you want to be in football, you got to go in football. Uh, I've seen people make the transition if they'd been in other collision sports, but you got to be in sports where you see a lot of everything, because there's a lot of. There's a lot of non contact injuries. There's a lot of overuse injuries and there's a lot of collision injuries. So, um, if you want to be in football, you should, you should start thinking about how to do that. Now, uh, the other thing I'd say is make sure you get a good mentor. Uh, Too many times. I think the patience and it's a self, it, it's not a pro, it's, it's not a problem for young people, but there's self gratification.'cause you could pick up your phone and you could find out any bit of information that you want. You don't know. It's always true, but you could find out, out any information that you want. So stay patient. It's not an easy, it's not, you'll do a lot of stuff for nothing and you'll do a lot of grunt work in the beginning. But if you talk to the younger people that are in the NFL, they will tell you that it may have taken three seasonal internships until they were offered a position. So you've got to be patient if you want to do it. Right. And in the meantime, should they try to find a collegiate setting, at least get some football experience? Heck yeah. I always tell people if they've been a seasonal one or two years, then go, because you got to hone your skills then, because even when you're a seasonal, you're not, you're treating people and you're. Getting to do some mini evals, but I'd rather see somebody that's gone and they've been in charge of Their their second in command of a football team and now they're doing all the evals. They're doing the return to play on the field Because that's that's how you start to get your system worked out That's great. Well, Pete, before we let you go, we'd love to end the episode with a high five, five quick questions, five quick answers, just to kind of learn a little bit about you and your mindset a little bit. But first question is what are you currently doing for your own professional development right now? Uh, for me, it's all about soft tissue, and it's anything to do with soft tissue, whether you're looking at lengthening it, you're looking at, uh, so if it's an ART, if it's, if I'm looking at activating it, such as MAT, if I'm looking at fascial, uh, points, such as stecho, so anything fasciitis, um, From a standpoint, fascist fashion is a fascinating topic because it's it's never really been there in the in the schooling that I went through, but we could see its connection and what its relationship is the muscle now and how it transfers forces and kinetic linking regional interdependence and what it all means. So. But soft tissue right now is like the, the thing that I spend most of my time on. Thankfully for the jaguars too, right? Because that, that's your, that's your number one goal. What's one thing that you recently changed your mind about? Uh, that I've changed my mind about? Um, I'd say that I've gotten a little bit better at recognizing that the body will do more And then I need to push that a person needs to do something every second, every day to get better. Sometimes it needs rest and rest is the thing that it gets least of in sport. So that would be the one thing I've allowed more rest. I'll do less. And the other thing in our world, guess what happens? They don't only get treatment with us, they're getting treatment outside of the place by their group of people that's helped them along the way. So I've always thought staying in communication with them is important and I fill in the gap. So if they're not getting strength, I'm going to spend my time on strength. So I've done a better job, I think, of that. But the main thing is, uh, again, being more patient with knowing that this, this is how long it actually takes. Healing's biology. It's not technology. Oh, good one. I love it. Well, there's already been so many gems in this episode, but what's your favorite piece of advice that you love to give students? Uh, basically be patient and find a good mentor because it's like I said, I mean, I went, I went through as a, uh, a graduate assistant football coach. a student trainer at Gettysburg College, a athletic training student at University of Delaware to a high school, to a, uh, to a college at Lehigh, and ended up going to PT school at Miami. And what happened, some circumstances happened down there, and I was just going to be helping out. Well, what happened is one person had to end up leaving, and now instead of wanting me to help, they needed me to help. So that was my end. So you never know when that's going to happen. And again, timing's everything. Mike will tell you, timing is everything. For sure. I love it. What's coming up next for you? I mean, do we, have you worked in the NBA yet? Or is that, is that on the docket or what's next? No, at HSS, we saw a lot of basketball players. No, I'm, I'm in the, I'm in the twilight right now. I figure if I could do this another three or four years, I'd be happy. And then I'll sit down and I'm going to put something together. Uh, that that just spells out the seamlessness for people to be able to look at so that they don't make the same mistakes that I did that. Like I said, it might be 34 years. But, uh, but again, I'll be calling you because I don't know that there's anybody in, in, in the rehab world for sure. And he may be even in medicine that's figured out how to do it as well as you have. And people don't realize how much time he put in. You're a clinician. The reason I respect guys like you and, and, and Voight and, and people like that is you're not only out here talking. You're not only putting stuff out there, but your clinicians, you're on the floor, you're in the so you see when things change. I really don't respect anybody that goes out and does all the talking. They're academic based, but they don't see anybody. I don't have being honest. I don't have any respect for those people because I mean, look, look at you. You're you're you go. You talk about performance and you put a performance program together for people. Why? Because you were in it. Some people are out there talking about return to sport and they've never in a weight room. They were never on a field and never told me what to do. I'm you. I, I, I, I And that's why I'm excited. So I, I'm not in a rush for you to, to move on from the Jaguars, but I'm excited for you to produce that next thing. Cause I do think a lot of people can learn from that experience. So that's awesome. But, um, Pete, where can people learn more about you? Are you on social media anywhere? Is there anywhere? I know, obviously we can find you on, you know, some of your articles on PubMed and stuff, but is there anywhere people can go to find more about you? I haven't, I haven't done that. I'm old school yet. You know, I'll be knocking on your door in about three years when I think about this up because you've done it better than anybody. And, uh, but, but right now, and again, in the NFL, we try to, you know, Again, uh, you make an obligation to the team. You don't want to share certain things. It's, it's not necessarily proprietary when you're writing, but what it is, is it, it's, it's a competitive advantage when you know something that someone else might not know. That's right. Yeah. It's tough. I've been, I've been patient with controlling the commercial side of what could happen as opposed to, uh, just doing what I'm supposed to do now. That's great. That's great. Well, awesome. Well, Pete, thank you so much. And good luck the rest of the season. Um, that was a ton of great wisdom and experience that you shared. I think people are going to get a lot out of it. Be sure to go to the show notes and check out the link to Pete's article and learn more about his return to sport continuum. I thought that was a really neat article that I wanted to talk about. And again, thank you so much for joining us. Thanks for having me, Mike. Appreciate it. Good luck with heat for you too. Boom.