Injury Prevention and Rehabilitation in the MLS Bubble

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The Heath & Performance team at the Portland Timbers have their work cut out at present.

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By John Portch

In the past two months, the team has experienced the Florida bubble at the MLS is Back tournament and has been unable to train outside in recent weeks due to the hazardous air quality on the West Coast. Covid-19 Protocols also dictated they make the 1,126-mile round trip to San Jose twice in four days.

“We have to be flexible and adaptable as a Health & Performance team to support our coaches and our players in the best way we can knowing that we don’t know what’s going to happen the next day,” Nick Milonas, the Director of Sports Science at Portland, tells the Leaders Performance Institute ahead of that first meeting with San Jose.

Milonas has retreated to the one corner of his San Jose hotel room where the guest Wi-Fi permits us an adequate Zoom connection. The topic of conversation is performance modalities and how they are put to the test in trying circumstances.

We discuss the Timbers’ relationship with Sparta Science, a human performance data company in the Silicon Valley. Sparta Science is the leader in the application of movement diagnostic software. Using Force Plate Machine Learning™ [FPML™], the Sparta System identifies how you move [your movement signature], and provides individualized, evidence-based plans to help you move better.

“This is the third year of our relationship with Sparta,” Milonas continues, “and every year has been constantly evolving into a place where we’re trying to utilize the information that is provided by their force plate software to help program for our athletes in the most efficient manner and look to gain as much effectiveness as possible, whether that’s within a one-on-one setting or programming collectively on a weekly basis for our team. It could be understanding their recovery and where our players are from a readiness standpoint leading into a match or even within the rehabilitation process and trying to understand when and where we can push them safely and efficiently as well.”

“We and a couple of others are the first in MLS to really start using it,” says Charles Burdick, the First Team Performance Coach, who joins us online from Portland where he has remained to work with some of the players who did not make the trip south with the rest of the roster.

“At first, it started out that we were maybe doing one jump once or twice a month and we were really only doing the plank scan at the beginning of the year and the balance scan at the beginning of the year and really using that as a return to play baseline.”

The Jump Scan shows how an individual produces force. Essentially, it looks at how an athlete creates, transfers, and prolongs force, which differs based on fiber type, previous injuries, and training background. The Balance Scan gives more information on the nervous system, but especially highlights the vestibular system to show how much stability the athlete has in both left and right lower limbs. Then the Plank Scan really magnifies the connection between the lower and upper limbs assessing the trunk and global stability down the entire kinetic chain.

“That evolved all the time and we incorporated the jump and the plank scan on a weekly basis so that we can utilize that information and be a little bit more refined with our monitoring process.

“If somebody came in during the pre-season and, say, we might be trying to focus on increasing their drive and trying to balance out their movement score, their movement pattern, their movement signature, and try to find that balance and build them into a more balanced athlete; so using that to monitor them over that time, anywhere from three to six weeks or more and try to get the test on a weekly basis.”

‘The players are having fun’

Milonas arrived at Portland ahead of the 2014 MLS season, with Burdick joining a year later. Both are keys figure in the Health & Performance Team that Timbers Head Coach Giovanni Savarese finds invaluable. “At the end of the day, you can have a plan, an idea, and a way of working,” Savarese told The Athletic in August, “[but] you need a good staff.” The Venezuelan was speaking ahead of the MLS is Back final, in which his side beat Orlando City 2-1 with goals from Larrys Mabiala and Dario Župarić.

That competition, which took place behind closed doors at the ESPN Wide World of Sports Complex in the Walt Disney World Resort in Bay Lake, Florida, saw 24 teams contest 51 games in 39 days in hot and humid conditions. There were also in excess of 35,000 Covid-19 tests taken by staff and players across the duration of the bubble.

Not only did the climate and tight turnaround pose problems, but the players and staff were separated from their families and other loved ones. “Being away from family and significant others was an additional stress upon everyone – all the players, staff and everyone involved in the project,” says Milonas. “Then looking to set up an environment where guys can stay focused on why we’re there and try to compete in the best way we can with a preparation that is not necessarily ideal.”

‘Ideal’ feels like a quaint concept in a league where the Timbers’ annual travel regularly exceeds 45,000 miles. “For the most part, the amount of travel we have to do, especially when we’re making the big trips out east, is definitely a toll on the body,” Burdick admits. “We try to utilize the various assessments through Sparta to monitor the players’ neural systems and see how they’re responding to the amount of extra stress that’s been placed on them from the travel, plus recovering from the travel and the game on top of that once they get back.”

The pandemic, however, posed more complex problems. “We came out of quarantine in two or three different phases: individual, small group, then a full team training phase, leading to traveling to Orlando,” Milonas explains. “Then we had to take into account the adjustments of the time change and climate change that we’re not necessarily too familiar with being in the Pacific north west in comparison to the Florida summer.” The Timbers’ reputation as a strong tournament team under Savarese was going to be challenged at every step of the way.

“With all that being said, it was important for us as a staff to make sure we try to set up an environment where we can control what we can control.” From the Health & Performance team’s perspective, that meant bringing their own performance and medical modalities and setting up a mini facility that exceeded those provided onsite in Florida.

“We took it upon ourselves to make sure that we could create that environment and create a schedule that will not be interrupted due to anyone else’s schedule or routines. It was all based around us. I think that was a really big step in terms of taking what we thought was important from our facility in order to provide the same service consistently while we were down there.”

In the Timbers’ search for accuracy and reliability, Sparta Science has become a staple. “It’s developed into something that we use on a daily and weekly basis,” says Burdick. “Sparta has become a foundational aspect of our process, especially from a strength & conditioning and return to play standpoint. It gives us a lot of high quality information that’s super easy to collect and utilize right away. That’s one of the things that we love so much, the simplicity of it; and the powerful information that we get.”

When results are posted it creates an element of competition within the playing group. “Our athletes seem to like it as well, so I think that’s the No1 thing,” he adds. “They’re having fun with it.”

Creating data that appeals to players has been a big factor. “They’re becoming very comfortable with the system as it’s very user-friendly,” says Milonas. “This allows us to have a conversation about their current movement signature; what does it mean, what can they improve on.”

Information is tiered depending on the member of staff or the athletes’ preferences. “Obviously some athletes are more interested than others,” he admits. “We use it as an educational component too to give them a better understanding not only of what Sparta is showing but also how it also ties into the rest of the program. It’s not just a bunch of numbers – guys can actually see their trend over time.

“Their understanding of a movement signature and how that can relate to what they’re doing in the gym to ultimately support what they’re doing on the field whether that’s from a preventative standpoint or getting the most out of their particular performance on a regular basis in training and hopefully when they get the opportunity to express that skill in a match.

“As a practitioner within our team, I think it also helps us visually see the trends over time. It definitely takes time in how we utilize the information but also not only for performance but bringing an athlete back from either a short-term or a long-term injury to give us a better idea of where they were prior to injury. So very helpful at multiple ends.”

Monitoring readiness and optimizing physical work

There are always injuries in sport – in mid-September Timbers midfielder Sebastián Blanco underwent surgery on his ruptured ACL – but the Health & Performance Team continually work with Sparta Science to reduce a player’s risk and aid rehabilitation.

Burdick says: “We ask players to take the jump and everyone has their individual jump and then whether it’s how low do they explode to the drive; and then from there that’s really going to drive the type of training that we’re going to give the guys off the field to try and mitigate those chances of injuries.”

“If they have low load, the likelihood of maybe having tendinitis or Achilles tendinitis goes right up, so we try to get way out ahead of those to try and start working on isometrics and different loading patterns. Even just utilizing Sparta’s recommended exercises into the low drive or explode to try and get out in front of the typical injuries you’re going to see from having those patterns.

“We just to make sure we’re being as proactive as we can be so they can stay on the field and continue to participate in training and staying as fit as they can.”

As an example of monitoring readiness and optimizing physical work, Milonas cites the plank scan: “We try to use it on a weekly basis just to monitor the guys’ level of pelvic stability and trunk stability to make sure they’re recovering from the games and staying strong, to make sure we’re attacking the right patterns and the right strength & conditioning protocols that we need to make sure they’re staying on the field and recovering from the games.”

The MLS regular season is underway again but were there also lessons learned in Orlando? “The processes that we have here in Portland, we were able to put them in place at an even higher level there because there was full commitment and full concentration for us being there in the bubble and you could really see it come to light really well,” Milonas replies.

“On the flipside, we learnt that giving our players the appropriate support and autonomy throughout that process was really important as well because we couldn’t be on top of them 12 hours a day. As focused as we are when we’re back in Portland or in a usual season, and that rhythm that comes with it, I think we also had to take our foot off the pedal a little bit in terms of making sure that guys felt as comfortable and had their own time, but knowing that they were going to do what was necessary to get them in the best position to prepare for a match or training.”

The club’s relationship with Sparta Science continues to evolve as Milonas seeks to improve the Timbers’ athlete profiling and talent identification. “We as a club are still evolving in that facet and I think the information Sparta provides off their simple and effective scanning procedures give us a good understanding of their movement signatures and profiles at that particular moment. Our professional athletes – men and women – are tested on the platform on a regular basis. We can start to make those comparisons and get a better understanding of where certain athletes may lie.

“I do think it’s definitely a growing component within our program. I think this would be a next step as the relationship grows between the Timbers and Sparta.”

At the end of the day, as Burdick admits, winning games and lifting trophies vindicates the work of the Health & Performance team. “In combination with everyone involved, it helps us get to the next level and win games. After winning a tournament it goes to show that as a health and performance group, we’re the team behind the team and we’re doing a pretty good job. Just like any team, we have room to get better and we strive like any team to improve as much as we can.

“We’re going to continue to do that as we want to keep winning – winning’s a lot of fun and it keeps us in business.”

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