A Pro Sports Doctor Reveals What Actually Works for Recovery (And What You’re Wasting Time On)

[00:00:13] Okay, so for anyone who's stumbling across this conversation with us, what do they need to understand about you to understand the expertise and sort of the topics that we're going to be covering today? Yeah, sure. So I'm Ashwin Babu. I'm a sports medicine physician, specifically a physiatrist or a specialist in physical medicine and rehabilitation. I work at Mass General Brigham and the Spalding Rehabilitation Hospital in Boston. I have a lot of expertise with the non-operative management of different sports injuries.

[00:00:41] I see athletes from the elite level athletes down to the recreational weekend warrior types. Love all of it. And I've done this for a little over 10 years now. Okay. Weekend warrior. I like that term because that's what I'll call myself here in the context of this conversation. So how long have you been doing this? You said 10 years? Yeah, so a little over 10 years. Yeah, I finished my fellowship in 2016 and got hired straight on and I've been there ever since.

[00:01:05] Yeah. What's the biggest sort of eye-opening thing you've seen in terms of the recovery component, especially when you're dealing with high-level athletes and then how that translates or if there's really any difference for the quote-unquote everyday weekend warrior?

[00:01:22] Yeah, absolutely. Yeah. So I think the thing that stands out the most when you kind of see athletes kind of across the spectrum is just how seriously professional-level athletes take the recovery piece and how often more recreational athletes kind of don't think about it so much.

[00:01:41] Recovery commonly in the recreational space is just the absence of exercise, you know what I mean, as opposed to whereas it's an active part of almost all professional athletes kind of day and week and training schedule. And so they think of recovery very seriously, very deliberately, and they incorporate it into their training programs. And I think that's something that most recreational athletes don't necessarily need to do with the same attention but certainly should be cognizant of in much the same way.

[00:02:08] And so I would say that is what's most eye-opening is just how differently that perspective changes across the spectrum. What's it like working with elite athletes? Yeah, it's awesome. It's really fun. You name any that you, like, are you allowed to? Yeah, that's why I don't know the specific rules, so I'm going to err on the side of caution. Okay, fair. Can you talk about teams though that you've worked with? Yeah, exactly. I work with the Boston Bruins, the New England Revolution. We don't like the Bruins here in Toronto. Yeah, exactly. Maybe not the most popular thing at the time.

[00:02:37] If you don't do a good job, I would be okay with that. Yeah, right, right. Exactly. Yeah, so Boston Bruins, the New England Revolution, the Patriots, a lot of the pro teams in the Boston area, also a lot of the collegiate athletes through Harvard, Curry College, all the local stuff there. And, yeah, it's incredible. They're remarkable people. So treating pro athletes is incredible. I mean, they're just remarkable individuals.

[00:03:02] And it's also really cool to interact with folks at the very top of what they do. And their work ethic, their passion for their livelihood is just, it's really remarkable and really fun to be a part of. And what's also really very cool is that a lot of them just, they're like regular guys. Are they really? Yeah, just happen to be incredible at a very particular thing.

[00:03:26] But they come to you with the same concerns, the same kind of human aspect that all recreational athletes and everybody has. The difference, of course, is that the stakes are so much higher. And so it's appropriately a little more of a big deal for them. So, you know, their livelihoods are at stake when there's a big injury. And so they feel the appropriate intensity of those decisions around their health care. But other than that, they're just great guys. And it's a true pleasure to get to work with all of them. So give me an example.

[00:03:55] If someone, an athlete comes to you or the team, I guess, comes to you, is there a reason they use the hospital for this? Like what's the correlation or the relationship there? Yeah, so there's not like one uniform way this all works. There's a lot of different relationships. And so, you know, we have an incredible team at Mass General Brigham in Boston where we have relationships with almost all the major pro teams in the area. And so all of the – there's always one physician who kind of quarterbacks all the care and is their kind of main go-to.

[00:04:24] And there's usually someone from the orthopedic side, someone from the primary care sports side. And so depending on what the issue is, they'll get funneled to the appropriate team. But what's really important is that over at MGB, we have an incredibly wide and deep bench. And so there's a lot of folks with remarkable levels of expertise. So kind of whatever the problem is, we can get them to the right place to make sure we cared for it properly. And so what will commonly happen is either I'll be in the training room after a game and something will happen. We'll see the athlete right then.

[00:04:53] Or I'll get a call from one of my colleagues. And, you know, I turned my cell off for this. And it's very few times in the last 10 years my cell has been off because it's on. Why, thank you. Yeah, it can go off any time. Again, I'm not so sad here if a Boston player – If they miss a call, yeah, exactly. It'll be waiting for you when it's gone, I promise. Yeah. And so, you know, what ends up happening is you get a call and the answer is, of course, let's take care of them. Let's do what we have to do. And it's really quite remarkable to have so much expertise so closely.

[00:05:23] You can always get to the right person that you need. You made a point earlier that I want to come back to. You know, we essentially spend so much of our time and energy either training, in the gym, doing the physical exertion, whether it's playing a sport, running a marathon, whatever the case may be. And we don't spend enough time thinking about recovery. We don't spend enough time thinking about taking care of our bodies. And that's a huge problem. I'm starting to learn that now because only now am I starting to think about recovery. Why is recovery so important at the most basic of levels?

[00:05:53] Yeah. The short answer is from a physiologic standpoint, when you're doing a lot of exercise, you are taxing your body in a certain way. You're breaking down muscle fibers. You're doing all the things that are appropriate and good for you from an exercise standpoint. But it's only half of the equation. The body then needs to be able to recover and build back a little bit stronger. And then you can go again. And you can do a little bit more and let it recover. And there's different ways to think about this.

[00:06:19] There's many different kind of frameworks to think about increasing your exercise through cyclic nature and slowly in an acute workload versus a more chronic workload. But the general principle here is that you need to push your body and give it the time, the resources, and everything that it needs to build back up stronger. Then you can do it again. And this kind of cyclic nature is very, very good for you over the long haul. And if you only do half of the equation, it's just not going to work so well. You're going to run into trouble.

[00:06:46] And so really giving the recovery the attention it needs is really quite important. Yeah. But there's also all these important things like adequate nutrition, adequate sleep. And these things really make a big difference. Let's talk about that. The nutrition component, sleep, I definitely want to get into because I'm a new dad and I haven't slept in four months. And I'm feeling the effects of it.

[00:07:15] And I'm trying to train for an ultramarathon and I'm like, I don't have the energy. The recovery is slower than it was last year or so. But before we get into the sleep piece, the nutrition component, we don't think enough about what we consume. And generally speaking in North America, we're more prone to eating really awful processed foods because it's easier. We've got a very quick and fast lifestyle. It's convenient. Why is that a problem? Yeah.

[00:07:44] You know, there are a lot of the stuff that's in some of the processed foods just isn't good for you. And it doesn't facilitate this long-term healthy behavior. What we really need is to be consuming all the different food groups. There's so much information out there. It can get confusing. There's fad diets and all kinds of other things that are around. In general, what really matters is that you're consuming as whole foods as you can get a hold of, preparing your foods at home if you're able to as much as you can.

[00:08:10] And consuming a balanced diet, staying away from too much sugar and processed foods and staying away from too much alcohol, smoking, nicotine, things like that. All of that's just so bad for you. And if you can dial those things in well, it's such an important basis to improve your lifespan and how healthy you are and how much you're able to do. These are really just the key, key elements. And I think you hit it right on the head, which is it's less convenient to do it that way by a lot.

[00:08:39] And you're a new dad. You know this. And time is not available. I had cereal today. That's all I've had. Yeah, right. Exactly. And that's so common, right? And so it is a real challenge. And it is the challenge, really, for most of us. And just because it's a challenge and it's hard doesn't make the science not real. It's still there. It still has to be done. But we should acknowledge that it is extraordinarily difficult, but it is worth the time and effort to put in.

[00:09:05] So what advice would you give to someone listening or watching this who's actively thinking about how they want to change their nutrition? Yeah, I think it doesn't have to be overly complicated, right? You need to hit all the major food groups. There's many different well-established kind of descriptive guidelines as to what you need. I think most people know this. There's a certain amount of carbohydrate, lean proteins, healthy fats, decreasing the amount of sugar, sugary drinks, sodas, things like that that aren't good for you.

[00:09:34] And consuming as unprocessed foods as you can get a handle on is going to help. And so these are the general principles. And what I would also encourage people, and I take every opportunity I can in my clinical practice, is to get folks in front of a sports nutritionist or a nutritionist in general. These are folks who have remarkable levels of expertise. We have tons of them at Mass General Brigham who do such a good job. And when I have an athlete who has an obvious problem that needs correcting, I take every opportunity to get them there.

[00:10:04] And it makes a big difference. They're able to break things down in a very digestible way. And athletes are the better for it. And so get the help that you need. Yeah. I think it's interesting because, you know, the average person, and when I say average, I don't mean they're an average person. I just mean the person who's not necessarily competing at the high level. Exactly. Doesn't necessarily think about nutrition in the same way an athlete would because it's so integral to their performance on the court, on the pitch, you name it.

[00:10:32] But what you consume, and more importantly, maybe what you don't consume, has a direct impact on your physical abilities, your mental health, your sleep, your emotional resiliency, all of those different things. Yeah, absolutely. And I think, yeah, it has to be – it needs the attention that it should be given. It sometimes gets pushed to the side when other things kind of take over.

[00:10:54] And I think going to the gym and lifting heavy weights in a very specific kind of narrow framework is incredibly important but is insufficient. It's only part of the whole story. The whole thing needs attention. Should somebody be exercising every single day? Yeah. So this is an interesting topic, and it has to be framed appropriately. It depends on what we mean by exercise. It depends on who we're talking about. And when you have a clinical sports medicine practice, you see all kinds of folks going on.

[00:11:22] Someone who has never exercised or certainly not recently is on the couch for the most part, sedentary job, that sort of thing, should not go straight into exercising five days every day, high level. You're going to run into trouble. That's pretty clear. Yeah, it's too much. The body does remarkably well adapting to slow changes. And so we should let the body do that. It doesn't do so well when you kind of hit it too hard too quick. And so this is what needs to happen.

[00:11:50] So I would say exercising every day isn't itself a problem if it's done appropriately as part of an overall framework. It can't be the same actually. You can't do bicep curls every day, right? It has to be some weightlifting. There should be some cardiovascular exercise. There's really well-established kind of exercise doses that people should pay attention to. And so you need a certain amount of cardiovascular exercise. You need a certain amount of resistance exercise.

[00:12:13] How you divvy it up, I don't necessarily feel the need to get too prescriptive to because what works for the individual is the right answer. What they care about more than anything is that they're doing it. And I tell athletes all the time, I don't really care what your exercise is. As long as you enjoy it and you're doing it regularly, we're winning the game. It doesn't really much matter what it is. We can adjust around what that is. And so it's one of the most important first things when you have an athlete in front of you is to establish what are your goals? What do you like doing? And we'll build around that.

[00:12:43] And everyone's different. And because they're different, the answer to that question, can you work out every day, will be very, very different. If your goal is powerlifting and want to be competing, that's going to be a little challenging. We have to make some adjustments there for longevity. There's probably a way to work in some of these, but not everybody needs an every single day plan. There should be the active recovery built in. And so different ways of thinking about it.

[00:13:07] I think people sometimes forget about the component that recovery offers to your overall plans. Whether you're lifting heavy, you're training for a marathon, you're just trying to stay fit, actively baking into your schedule, a recovery day or two or three as needed type of thing. But most importantly, listening to your body, because it's really and truly your body that's going to tell you, hey, today we're going to need it. Yeah, we're going to need a day off today.

[00:13:35] Or if you're going to do it, maybe take it a little bit easy because we don't have that much in the tank. Yeah, exactly. Which makes me think about those pre-workouts and all that boost in caffeine to get your energy levels up, but the body is still telling you, I shouldn't be here right now. Yeah. I'll think of that in the way I think of almost all kind of supplements and stuff that you add in. They all probably have a role in very specific areas and in high levels of performance.

[00:14:03] You know, caffeine is well studied and has really good efficacy for certain parameters of exercise output. But for most people, maybe not don't need that. If you do the basics right, that's plenty. And so what I find to be most useful is to give people these very loose but general frameworks and say now mold that to what works best for you. For a new dad, it's going to be different. Somebody who's doing other things, it doesn't matter, right? Again, you've got to get most people out there doing what they like to do.

[00:14:32] And it works out well. And so I think of some of the pre-workout stuff as a perfectly fine adjunct. As long as it doesn't interfere with the basics, I'm okay with it. Caffeine itself isn't a problem. You can absolutely take too much to cause trouble. But it's certainly not a necessary component. If someone told me they didn't want to do it, I was like, that's great. No problem. No problem at all. I understand that you're not technically a nutritionist. But given what you've seen in the practice that you're doing daily, is there specific

[00:15:02] foods that you could recommend that helps fuel recovery? Yeah. I don't delve into that level of granularity too often. I almost always, when we need that level of specificity, which comes up not uncommonly, but when we need that, I have a professional who does this all day, every day. I, again, I'm spoiled at MGB. We have so many people who do such a good job of these things that I just, I don't really have to. And so because of that, when it comes to, I'll get that question.

[00:15:31] What should fuel my specific recovery and my specific program? I said, I'm going to get you a very specific answer and let them do it because this is what they do all day long. And there are, the answers differ for people. And so we need to know exactly, you know, I want tailored advice for them. Personalized care is really the key there. And it works well. So do you see a difference between athletes across different sports? In terms of like the type of recovery. So the ones that are coming to see you at the hospital, are you seeing a difference between

[00:15:59] the hockey player versus the soccer player versus the basketball player and so on? Yeah. Yeah. Different sports, of course, have very different. I think like to make an easy example to discuss, right? The, you know, we have the Boston Marathon, of course. And so every year we'll get a whole group of people maybe doing their first marathon, maybe their 20th. And they are themselves very different. And overall, they're very different than the recreational hockey player who I'll get pretty commonly. And the older soccer athlete taking part in one of the rec leagues. They're all different.

[00:16:26] And they have different kind of injury patterns that show up. They have different needs from a nutrition and a recovery standpoint. So you kind of have to tailor your care specific to them. There are principles that kind of come out in general and a lot of overuse injuries in almost all of them. But yeah, they are quite different. They show up with different levels of muscle mass, different levels of lean muscle mass, different levels of bone injuries, things like that. So it really is quite challenging and a fun part of the job. I want to go back to sleep.

[00:16:56] Yeah, let's do it. I think of sleep like a natural steroid. It's the body's most purest form of recovery. Yeah. I was recently traveling. I went to the UAE to visit Dubai and the flight path back and everything was just extremely long. The travel ended up being almost 20 plus hours. And I got home at about 2.30, 3 o'clock in the afternoon. I had a bite and then I fell asleep and didn't wake up until 4 the next morning.

[00:17:24] It's never happened to me before, but I felt refreshed after that. And it just reinforces this idea that no matter what's happening in your life, whether it's emotional, mental, or physical, sleep has such a profound impact on us. Maybe you can share a little bit of your insight into sleep and why that part is so important. Absolutely. So I think of, particularly in the context of athletes, I think of sleep as one of the cornerstones of that recovery pattern. And to kind of take it back to what we were talking about before, one of the differences

[00:17:52] between elite and recreational athletes, this is one where elite level athletes can have a tough time because of the constant travel. And it makes their lives very challenging. They're spending a lot of time not in their environment. And one thing that often helps people who struggle with sleep is having this kind of reproducible home environment that they can get together with. Because they don't have that, they sometimes struggle a lot with the sleep side. And recreational athletes, for the most part, have a reproducible environment. So they're able to have a little more control in that.

[00:18:18] And so I think of it as an incredibly important component. And sleep is itself a whole discipline of medicine. Another area where we have particular specialists, which help a tremendous amount when athletes have certain problems that make them unable to get adequate sleep. But a lot of the kind of tenets that we talk a lot about is making sure people aren't consuming too much caffeine or alcohol too close to bed. These things kind of are common, simple fixes that can make a big difference.

[00:18:47] And making sure that they have, again, these reproducible patterns of a bedtime routine. And people seem to do okay for the most part. The problem is almost always that life gets in the way. And they just can't squeeze the sleep in enough. And similar to the nutrition, similar to the broader discussion we're having about recovery, sleep needs the attention. It has to be, time has to be carved out for it. It doesn't make it easy. It has to be intentional. It has to be intentional. And it is a key tenet to getting athletes, keeping athletes out on the field or wherever they want to be.

[00:19:16] What's concerning to you based on what you're seeing? With the people that come in and see you, is there a trend that you're seeing that's like, hey, there's something that you're noticing, maybe a shift in the way people behave? Yeah, that's interesting. That's a great question. I think I'll take two components. The first is in the predominantly more youth athlete, what kind of gets me is that vaping and nicotine is back. And it kills me. Because it was gone. I thought we'd done it. Yeah, I thought we were done with that too.

[00:19:46] And we're seeing it again. And we're seeing like dipping. And it kills me. Because it is such an avoidable problem. And once it kind of has its hooks in people, it's really hard to get out. And it causes so much damage. And so to me, that is very alarming. Anytime I see, it was a couple years ago now, and I had an athlete who I'd seen for a variety of issues. And he was doing great. He was an elite level athlete.

[00:20:13] And as he was leaving, I saw a little pack of one of the tobacco things in his back. And I'm like, go back in the room. Go back in the room. I'm like 40 minutes late in clinic. And I'm like, I didn't yell at him. But I told him in very clear terms that this is not compatible with an elite level athlete. Not at all. This cannot happen. And he heard me. And it worked. And it's just, it is so, so important. So to me, that's very concerning.

[00:20:39] The other side that I see kind of more globally is, and I don't think this is new, but there's this reliance on like supplements or whatever the new thing is that can, you know, to help boost recovery or sleep or whatever it is that they're going. And all of it kind of falls in this category of stuff that maybe helps, isn't well studied enough to be sure, and certainly doesn't replace the basics.

[00:21:04] And what I worry about is that if there's so much attention and time and chat, GBT, Google, you know, or like, you know, like looking up of this, like that attention and time should be taken towards like sleeping and eating properly because that works really, really well. We don't have to worry about all this other stuff. And so, you know, maybe it's not quite alarming, but I think there's just, I feel more of a focus. I've certainly gotten more questions about it more recently. And the answer is always the same, which is just do the basics right. You're going to do just fine. And if we need to add stuff, we'll talk about it.

[00:21:33] But right now we got to get you doing the appropriate amount of cardiovascular resistance exercise, eating well, sleeping well. Yeah. Yeah. That's going to, that's going to carry you most of the way. I think it's extra concerning that people are turning to basically online search engines or AI to prescribe themselves with supplements and things like that without really realizing that you should see a professional first, have the professional determine if that specific

[00:22:02] supplement is actually needed, right? Versus just sort of blanket assuming. Yeah. Because someone, you know, took it and they had results and it might have an adverse reaction on your, on your body. Yeah. What I'll say is my experience in Boston, which in general, we have a kind of a very highly educated population. For the most part, it comes in. I get a lot of folks who have thrown into Claude or ChatGPT or whatever it is and have come to me with a tailored list of questions, which I don't, I don't hate at all. It's pretty good.

[00:22:32] And I say, great, let's go to them. Like, nope, nope, nope. Yeah. That's right. Nope. Nope. Like, okay, thanks. Like, no problem. Like, yeah. And they kind of, you know, there seems to be a trend of using it to kind of build a base of information and not necessarily trusting it. Now, the problem, of course, is these are folks who took the time to make an appointment to come see me to talk. So this is probably selecting for that group of people who are being a little more thoughtful about it. There probably are another group of folks who are not coming to see me. You know, they're just doing and going on their own. And that is concerning.

[00:23:00] You know, it's, it has been a little reassuring that I find folks kind of using it to build a base of information, particularly about things that aren't well studied, and then coming with legitimate questions, which is good. Can I ask you about head trauma? Yeah. Because major sports, that's become a very topical thing over the last decade, I'd say. Sometimes it feels like it gets swept under the rug.

[00:23:24] And if it's not mainstream enough, I was aware of things like CTE and just brain injuries and all that, like the sensitive nature of the way our brain works. But I was kind of like, okay, I hear about it. I'm going to keep watching sports on TV. Now I have a son. And I want to put my son into sports. And suddenly I'm having this conversation with my wife about whether we want to put him in sports like football or even hockey, which I'm a diehard fan, because I'm worried about head trauma.

[00:23:54] Yeah. I have had concussions. I know what that feels like. I can only imagine someone being hit by a six foot five dude with shoulder pads. Oh, yeah. What that would feel like. What don't people understand about the nature of head trauma in relation to these sports? So I'll start by talking about some of the good news. And then we're going to. If there's good news, that's fantastic. And the biggest good news is that in the last 10 years that I've been in clinical practice,

[00:24:22] the overall awareness of head injuries, concussions, how these should be things has changed drastically. And my perception of the average person's understanding of this is much, much more nuanced, much better than it used to be. So I think the signaling is working. It's not where it has to be, but it's substantially better. And I've seen this from the professional athletes who I'll come in.

[00:24:49] It's one of the most difficult parts of my job is when I cover the New England Revolution, the soccer. If there's a head injury, I have to evaluate them to decide whether or not it's safe for them to come on. And, you know, one of the biggest things I was worried about is athletes will try to minimize symptoms. And their subjective report, how they feel, is so instrumental to how we can make these decisions that I need honest answers. And I've felt a shift where athletes are being much more honest with me. And it is so reassuring.

[00:25:16] And I think we're really able to provide better care because of it. So this is the good news. I think it's fair. And another big little element to mention is that the research is getting better and more sophisticated. There's just a recent article came out by one of my friends and colleagues at Spalding, Dr. Dineshwar, showing how seriously we need to take some of these head injuries. And it got a lot of press. And it's just – it's a great study. The point is there's a lot of very well-designed papers coming out where our understanding is evolving and it is improving. So this is the good sign.

[00:25:45] Now, the part that you're kind of getting at is the dangers are very much there. They're real. And we know about them a little bit better, but they're still there. And it feels like there's no way to avoid them. Yeah, and that's what's tricky. The sports nature just doesn't allow for that to not happen. They can be adjusted though. So rule changes have made a big difference in the individual place. When you look, there's a handful of studies showing rule changes are decreasing concussion risk and things like that in a variety of different sports. So the point is there are ways to make it safer.

[00:26:12] We're also understanding at what point a youth athlete can safely sustain some sport-related head impacts without causing trouble. And we've kind of understood that we have to be a little bit careful about younger athletes with less neck control. And, you know, the ratio of the size of their brains to the rest of their body is different. And so understanding how those anatomic factors contribute to their risk of head injuries, that science is evolving. And because of that, we're getting better recommendations.

[00:26:38] But I have a three-and-a-half-year-old myself, and we have the same conversations where I'm quite worried about it. I don't want to sustain any big head injuries too soon or ever if I can avoid it. But that is challenging to do in these contact sports. And what I always try to think about is it's very easy to say, forget it. You're not playing hockey. You're not playing anything. You are going to run. You're not playing chess. That's it, right? But the point we've got to remember is that—

[00:27:07] Chess just hurts the brain. Yeah, right. Exactly. Different kind of injury. I'm fatigued after that, right? No, but I think that what I think about is how important sports are for the development of a youth athlete globally, right? Head injuries are a big deal, and this should not be minimized. But that is a part of overall, the physical nature of it, the healthy habits that get instilled as a result of being part of a team, the social impact of being a team, the self-efficacy, the self-confidence.

[00:27:35] All the things that are related to sport-related activity throughout their lifetime is critically important. And so we have to weigh these scales appropriately. And as the way to help make these decisions, which are difficult, better, is to get more and more good science. And it is getting better. It's just we still have a lot more work to do.

[00:27:53] And so I think what I try to do is talk about that science as much as I can to my athletes, make sure everyone understands as best we know now what it is, support my colleagues who are doing this incredible work, make sure that it's out there so people understand what it is, and making sure that it gets the attention that it deserves. For parents out there who listen and watch this, we have quite a few.

[00:28:15] I'm curious what advice you can give them because they directly shape, especially for a younger athlete, they directly shape how they think about recovery, the importance of recovery, sleep, nutrition, avoiding head trauma, all of those different things. But it feels progressively more and more like parents are having a harder time communicating with their kids, especially if they're at a very competitive level. Yeah.

[00:28:42] Because you don't want to have, one, if you're the parent, you don't want your kid to somehow miss out because you've chosen to prioritize recovery over training and then suddenly, you know, they're not scoring and you think it's your fault. And on the flip side of that, you just don't want to be the reason they get injured because you didn't bake in enough recovery. So it's kind of a, you feel doomed if you do, doomed if you don't. So what advice can you share to maybe help alleviate that and maybe guide them? This is a tricky area that we deal with clinically all the time.

[00:29:12] And the, maybe the most kind of evidence-based overall principle that applies to this is we know that youth sports specialization is not good for athletes almost across the board. And so this is, comes directly to this tension that you're describing is where you want to get them enough training so that they have the skill development to maybe play at a higher, more competitive level later on, collegiate, professional, whatever it may be.

[00:29:41] But sports specialization is a real problem. And with that comes, you know, with sports specialization comes doing the same problem, the same kind of activity over and over again year round without breaks. And with that comes typical overuse injuries. And so it's less of a, did I bake enough recovery in that? That's not as commonly something that I worry so much about as it is. Are they just playing hockey all year round?

[00:30:08] And so I don't recall this where I grew up in New Jersey and, and I don't recall there being year round hockey. There might've been, I just wasn't part of, but I'm in Boston now and there absolutely is. There's that here. Every wall. Yeah, of course, certainly. Right. And, and, and so the point is, is having an athlete do the same sport all year round is, is what I worry about more. And so it's more on the macro scale.

[00:30:33] And so what I tell athletes and parents is what I want for your, your child, your young athlete is a couple different sports that don't share the same movement patterns. And I want a, an adequate break where they're doing just pure recovery. And so the old, you know, the classic three season athlete is great if you have a summer off. You know, so you play a fall, a winter and a spring sports are, at least in the U S that's the way it kind of was.

[00:31:02] You, you know, football in the fall, you did track and you know, winter track and then play baseball, you know, whatever three sports, different things, you know. And so, um, I love all of it, right. That that's great for you. Different sports, different movement patterns. I love it. Um, but there has to be like a break where the body can just recover. And I spend an enormous amount of clinic time talking to young athletes at the end. So they had an injury. They came to see me. We got them all the way back. And the last few visits, I spent a lot of time not talking about the medicine or the science.

[00:31:30] It's all, tell me what your overall macro recovery plan is. When, when do you get a break? Because the answer is often, I don't get one way, way, way too often. And so that's more where, where I kind of worry about this, um, as opposed to the weekly element on the kind of week to week element. The thing that does come up is being involved in many different teams. So, you know, I grew up loving baseball and this is a very well studied, um, in terms of like pitch counts.

[00:31:59] This comes up all the time. It's kind of well stated, right? So a youth athlete who's an incredible pitcher plays on a school team, his travel team, you know, and, and he does too many pitches too often. We know you need an overall, very much so. So we know that you have to have a certain amount after which, you know, your danger really increases. And so that same kind of principle though probably applies to other sports as well. And, and so, you know, I just want them, I don't want athletes on too many teams where they're playing almost every day, year round.

[00:32:26] And not only from a physical standpoint, but also from kind of a mental and emotional standpoint. Again, the big thing that I want, I think about this all the time with my son, what I want for him is to participate in sports for all of the other benefits. The, the fitness, the social, the self-efficacy you get from being good at a sport and the grit you develop from. Resiliency. Resiliency. Resiliency. And doing it anyway, right. That's what I want from him and for him.

[00:32:54] And, and what I want is the best way to develop that I think is to have a bunch of different sports spread apart. Yeah. And my wife and I joke about this is like, so what is our son going to do? Oh, well, he's obviously going to do, he's going to be great at this. And then this way. And the answer is he's going to do whatever he wants. Yeah. And we're going to end to that. Right. And try to fill these elements in because it's not sports specific. Both my wife and I play soccer. And so, gosh, we'd love for him to play soccer. I'm sure he's going to hate it. Right. He's like, I couldn't care less. It doesn't seem to be the case. He really likes it right now, but who knows?

[00:33:23] You know, and that, that is what it is. Right. It's great. Whatever it is that can get him those elements of exercise and youth participation, that is what I want for him. And splitting it apart, building inadequate breaks, making sure that he has the enough attention towards recovery, even at the youth's level will help get him there. Doc, thank you so much. Of course. The time flies. I swear I could probably talk to you for another two hours.

[00:33:47] Like, yeah, like I want to dive into the psychological effects on recovery because stress manifests itself physically. Right. And then that impacts athletes if you're not performing and you start to feel under stress. So I think it just means we've got to do a part two. Yeah, exactly. We've got to run back. But the one thing I want to clarify just before we wrap up is an everyday weekend warrior could basically walk into Mass General and say, hey, I need some support and assistance. Yeah. Yeah. So we have an enormous team. They're awesome.

[00:34:17] We have so many talented clinicians there. Folks from Canada specifically is massgeneralbrigham.org slash Canada. There's an entire team that exists to help facilitate this. We're there to help. We just love doing it. It's truly one of our passions is getting the weekend warrior athlete doing what they want to across their lifespan. That is what we do all day, every day. And so coming in, we're happy to help. Amazing. Doc, thank you so much. Of course. I really appreciate you. Really, really fun. This is great. Yeah. Thank you so much, everybody. Thank you. Thank you. Thank you. Thank you.