On January 27, 2016, Bill Belichick fired longtime strength and conditioning coach Harold Nash in response to a rash of Patriots player injuries. Assistant strength and conditioning coach Moses Cabrera was promoted to take his place. At the time, Belichick commented on the process of evaluating team injuries and strength and conditioning staff performance. “We evaluate that every year, and that’s always part of it,” Belichick said. “We go back and look at the previous year, look at historically the information that we have, what the nature of the injuries were, where they happened, what the circumstances were, practice, game, whatever it is and try to find trends or try to find ways based on the testing of the athletes prior to their injuries, whether there was any type of indication that there might be a vulnerability in some particular body part or imbalance or whatever it happens to be. So we’re always working on that, continue to do that as much as we can, try to stay ahead of it.”
Moses Cabrera working with a Patriots player (image credit to Patriots.com)
The Patriots look to be in better health so far this season. During his bye week conference call on Sunday Belichick seemed happy with the team’s progress.
“We’re halfway through the season and at this point, you can look at the numbers, relative to where we were a year ago, and see there is a significant improvement.” He went on to say “we’ve tried every year to work a little bit harder, try to do things a little bit better, and hopefully some of those little things are paying off. I know the players work extremely hard on their training as well as their nutrition, hydration, rest, recovery, all the things that go into performance.”
How can the elements of training and preparation that Bill Belichick mentioned above impact rate of injury? Effects of strength and conditioning are most seen with soft tissue injuries. Muscle strains and tears are the most directly affected. Muscle strains occur when the muscle is inflexible, overworked, and often dehydrated. There is also good data which shows that non-contact joint injuries can be reduced with certain training techniques – this is seen with proprioception (balance), targeted muscle strengthening, and muscle memory exercises leading to decreased rates of non-contact ACL tears in athletes. I would expect less impact on rates of what I’ll call “non-modifiable injuries,” which would include injuries that don’t usually involve strength and condition such as fingers, hands, toes, ribs, illnesses and concussions (although there is some thought that neck strengthening may help prevent concussions). Belichick commented Sunday on the types of injuries he thinks are most impacted by training:
“I’d say the thing we try to concentrate the most on are the injuries that we feel are most preventable and those being predominantly soft tissue injuries that are a function of training and hydration and nutrition, rest, and things like that. A broken bone or an impact hit that causes a problem, it’s hard to prevent those. Some of those are going to happen, although I do think there is an element of training that comes into play there, too […] But non-contact injuries, injuries that occur from, again, pulled muscle, from dehydration or fatigue or whatever happens, those are the ones that I think as a coach and as a staff you look back on and say, ‘Could we have done things differently there?'”
So, what do the numbers say? Is Belichick correct in saying that injury numbers are significantly improved this season compared to last season? From a distance, yes, the numbers look better. Mangameslost.com does an awesome job at compiling injury numbers reported in number of games missed for all players on each team. Here are their graphs for the first half of the 2015 season versus the first half of the 2016 season.
At the halfway mark in 2015, the Patriots had 73 games missed compared to 62 games missed at the halfway mark in 2016. Those numbers ranked the Patriots as 6th most injured team in wk 8 of 2015 whereas in the same week of 2016 they are ranked 20th. Sounds good, right? Unfortunately, upon further review, not so much.
First, look at the x axis of these graphs (the horizontal bottom line on the graphs for anyone who actively tried to forget high school math). Team total games missed due to injury. In 2015, the Patriots were pretty far to the right of most teams (only 5 teams were further to the right, hence their 6th place ranking). The Patriots were far to the right of the graph with only 73 injuries. Now scroll down to the 2016 graph. The 6th ranked team in terms of most injuries this season is Cleveland (CLE). They have 94 injuries. This means that injuries resulting in games missed are up across the league in the first half of 2016 compared to 2015.
Next, we have to look at the types of injuries that these numbers include and decide if we think that they are truly injuries that could be impacted by a change in strength and conditioning (modifiable). It turns out that the graphs include a fair number of injuries that I would not consider to be modifiable. I excluded the following injuries for the 2015 and 2016 seasons week 1-8:
Tarrell Brown, foot fracture (previous season)
Shaq Mason, hand
Ryan Wendell, illness
Rufus Johnson, illness
Marcus Cannon, toe
James Develin, shin fracture
Dont’a Hightower, ribs
Darryl Roberts, wrist
Chris Jones, calf (previous season)
Sebastian Vollmer, old knee injury
Tre Jackson, old knee injury
Dion Lewis, ACL (previous season)
If we exclude the above injuries from prior seasons, hand/finger/wrist, toe, ribs, concussions, and illnesses from the reported injury rates, the numbers look very different. With these exclusions there were 18 soft tissue injuries in the first half of the 2015 season and 33 soft tissue injuries in the first half of the 2016 season. It pains me to type this, but the rate of the types of injuries that Bill Belichick said he is working to prevent with his new strength and conditioning coach and more attention to preparation have actually doubled since last season.
Mike Petraglia of WEEI wrote about Belichick’s comments over the weekend. He reported that Belichick was gauging the team’s injury rate by looking at player availability. Belichick said that he went back and looked at last year’s game preparation notes and it seemed that the coaching staff was dealing with much fewer injury availability issues this year compared to last. In fact, Belichick said that there was such a difference that the Patriots developed an NFL first-world problem: with so many healthy players, who should they put on the field?
So how do we make sense of all of this? Is Bill Belichick being dishonest by uncharacteristically publicly praising his new head strength and conditioning coach? No, if you look at the data, Bill is correct. On the whole, the Patriots have had fewer games missed so far this season compared to last season. Given the publicly available data that I saw, however, I do not think that we can make a direct connection between the improved injury numbers and changes in strength and conditioning staff and procedures. In my reading of the data I excluded injuries that I don’t consider “modifiable” by change in strength and conditioning. However, there may be other factors at play that would effect these injury rates. For example, better player focus on rest, improved hydration and nutrition and the decision by coaches to send players home when they come to work sick may be the reason for the reduction in illness-related games lost this year. There may also be effects of conditioning that we don’t yet understand well – for example, strength and conditioning may in fact play a larger role in concussion prevention that we currently believe.
Finally, there’s straight-up luck. The Patriots have clearly had the football gods on their side through the first 8 weeks of the season with very few season-ending traumatic contact injuries. Although Belichick wasn’t willing to deny that luck plays a role, he’s taking a more long-term approach to injury prevention. “I think when you look at it over a longer view – five years, 10 years, 15 years, probably somewhere along the line there, there was a little more to it than that…not saying that isn’t part of it, it always probably is.” When it comes to injury prevention, I agree with the Patriots’ focus on the long haul. I think the Patriots are on the right path, studying player injury patterns and rates, tailoring their rest, nutrition, and strength and conditioning patterns to individual players. The numbers don’t lie, however. We’ll have to see how the second half of the season plays out, once players are a little bit more fatigued and have lost some of the muscle mass that they built up during the off-season. I hope that we see a continued low rate of injury, but we probably will not be able to judge the Patriots’ success in their efforts to decrease injury rates for at least a few more years.
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