Two Coaches & a Coffee

Season 2, Episode 37

• Darren Burgess & Jason Weber • Season 2 • Episode 37

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Unlock the secrets of transforming a PhD into a decade of career opportunities with doctors Darren Burgess and Jason Weber on Two Coaches in a Coffee. Discover how groundbreaking research and original work can be a launchpad for success, and hear personal stories of turning academic insights into thriving business ventures. We also pull back the curtain on the often-conflicting world of radiological and clinical evaluations in sports medicine, urging a holistic approach to athlete diagnosis and treatment that goes beyond the scan to treat the whole person.

Our conversation takes a vital turn toward athlete wellness, sparked by eye-opening revelations from a recent AFL-PA conference. With alarming statistics pointing to widespread body image issues among athletes, we advocate for more comprehensive and confidential assessment methods like DEXA scans, moving away from outdated practices. We stress the importance of handling athlete data with care and empathy, avoiding common pitfalls in the industry, and invite listeners to reflect on how our field has evolved over the years. Plus, a special nod to Phil Coles in Boston, a loyal listener who inspires us all.

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Jason Weber:

G'day and welcome to Two Coaches in a Coffee, doctors Darren Burgess and Jason Weber, here with you. How are you, burges?

Darren Burgess:

Doctors, that's very formal. Yeah, going, okay. Well, we got it.

Jason Weber:

You know what? You know what, mate? I figure we've got to throw it out there periodically. It always sounds weird when I say it, but you know, no, I think it's fair enough.

Darren Burgess:

I think you actually undersell yourself if you don't, because there's so much effort that goes into it. So you undersell yourself if you don't. So no, I'm all over it, Dr Weber. It's crazy.

Jason Weber:

We had a well, I had a conversation yesterday about PhDs and a lot of people doing them, and I do have a bent against some that are being done at the moment that are just rehash, rehash, rehash of things that have been done. Yes, they're just not original work. And I was speaking to a guy yesterday in the US about he's doing a PhD and I said one of the best things that I was told about my PhD by my main supervisor, professor Rob Newton, about my PhD by my main supervisor, professor Rob Newton, was your PhD should allow you to trade for 10 years on it. Now, what he meant by that is that the work should be sufficiently original that you should be able to get jobs off it like he did in academia. You become the guy that did that work and that's the body of work.

Jason Weber:

And in his case, he turned it into a business. A business, I mean, clearly I've done the same thing, um, but as, as things evolve, like you should be able to track to an extent, like you have, like you, you your phd in development has. We've often had conversations where you bring that work up which is, you know, absolutely, absolutely critical.

Darren Burgess:

Remind everybody that I got one Well.

Jason Weber:

I think yours is again unique and it serves an absolute purpose. When we get some of these ones that are regurgitating our training load and I'm still adamant we're not entirely looking at the right things, but that's another conversation well, I yeah.

Darren Burgess:

Anyway, speaking of doctors, all you said pretty, pretty. I said what I'm going to talk about? And you said doctors, radiologists. And then when we're so, when we're, we're in the green room preparing for 30 seconds.

Jason Weber:

All right. So I've had some interesting experiences over, let's say, the last month, and I might talk about them at more length later on and maybe in another context, who knows but been very interesting to the extent that one of the things that's bobbed up on my mind has been radiologists. Now, radiologists are unquestionably, in this day and age, incredibly important. They're a part of the machine, right, they're a part of the machine. They start the diagnosis process, right. So when we've got a question and interestingly, I must admit, this occurred, I really got this nailed with Frio under Ross Lyon. Ross was very big on diagnosis what's the diagnosis, Right? Yeah, 100%, let's get the radiologist get that picture. But the radiology is not the diagnosis, right, You've got a radiological view and you've got a clinical view. What's the clinical presentation like? Now? Oh, no consternation in the group already.

Darren Burgess:

Right, I'll give it to you no, go, keep going, keep going.

Jason Weber:

So the reason I bring that up is that recently I was given a. I was part of a review and that review had a situation where an athlete had a 3C hamstring, something that some of us are aware of on this podcast.

Darren Burgess:

Some of us One of us is very aware of it.

Jason Weber:

The other one's too old to move and get a hamstring injury, so no worries. But the staff said to me oh, we've just re-scanned it and the radiologist said we should slow down for a couple of weeks. I went ooh really. So the radiologist is making rehab recommendations. Yep, that's what's come down and that's what we're doing. So I just wanted to throw that into the meat grinder and, given you've already pulled faces at me, what do you think? No, it's just.

Darren Burgess:

I can imagine how the conversations went with you know Frio, with Ross at the time. Yeah, look, I think most people go with the adage of you treat the patient not the scan until they scan it, of you treat the patient not the scan until they scan it. So, and then a radiologist will say it's a you know grade one or whatever, and then you have to like you're almost negligent in your duty or in your responsibility as a doctor, medical practitioner, to not react to that and that's that's.

Darren Burgess:

Therein lies the problem, because functionally the athlete can be fine and do all your tests and they get through no problem, and they're same as pre-season values and all that sort of stuff yeah, but you've got to allow for tissue healing. And you're what tissue? It's epimysal, it's not actual muscle. But um, I can, I completely empathize and understand with uh doctors once the radiologist says it's a, there is some damage there, and and label it as such. So I don't know if that's a path you're going down, but oh, no, no, I'm not.

Jason Weber:

I guess I'm not a path. I'm looking. So what I would say without question is that, well, I said at the beginning, I said you have to have a radiological view and you have a clinical view to drive your diagnosis. What you can't do is what I think is inappropriate, is to be radiology-centric, which you just said Like when you treat the patient then you treat the scan, said like when you treat the patient then you treat the scan.

Jason Weber:

Because I've I've got some great stories recently of you know club doctors going berserk saying the scan says this, the scan says that we can't do it, but high performance manager, one in particular in afl, really just taking his time and say no, no, let's slow down. The clinical clinical signs are really good, let's just work. Okay, it's whatever it is, but we're just going to keep progressing. If it keeps ticking off the KPIs, we're going to go, but we're going to treat the patient and understand and acknowledge the scan, no problem. But I think I took I probably took umbrage a bit at us at a significant team in the UK saying to me oh, the radiologist has said we should slow down.

Jason Weber:

I'm like fuck really Like there were, and it's a complex situation. Clearly, without question, it's a speed scene involvement that I have. So I mean you're looking at at all. When you put all the data together, that probably was the right call, but it was the wrong reason. For mine it was the wrong rationale to have a team say, hey, the radiologist slowed down. There were other signals that, from a motor control perspective, I was recommending that certain things like yeah, you shouldn't go too much, don't emphasise speed at this point, like you still get him at seven, eight metres per second, just not full clip to 10. He was a fast cat, but the fact for a radiologist to and radiology is known to lag.

Darren Burgess:

Yeah, you'd agree, yeah, yeah, yeah. So what you're?

Jason Weber:

seeing on a scan may be residual, like your scan's behind what's actually happening clinically.

Darren Burgess:

So go on, mate. You're damned if you do, you're damned if you don't. Right Because let's say it's I don't know, let's say it's Liverpool, or let's use Chelsea, and it's a because and it's a $40 million player, 40 million pound player.

Jason Weber:

Yeah.

Darren Burgess:

And the radiologist says I don't think you should progress, and it's 40 million bucks, oh yeah, I can't, I can't. So you're damned if you do, you're damned if you don't, because any, any doctor that I've worked with worked with and I've got. You know, the doctor I'm working with at the moment is one of the best in the business in mark suzanna and he'll say, look, yep, the radiology is often a week to two weeks behind, particularly when it comes to stress issues and um. But you have to, um, you have to react to it, because once it's been scanned, you sort of can't ignore it. And so you know, and if you've got a radiologist saying something, you've sort of got to factor that in. And then you say, well, don't scan. And well, you have to scan to see what you're dealing with.

Jason Weber:

It's a vicious cycle, so I can completely understand it. Right, let's throw another grenade, all right, let's throw another grenade, all right, let's throw another grenade in the pack. In your experience and your preference, if you had your ideal setup whether you have that now or you had it in the past how many radiologists do you have?

Darren Burgess:

We use two.

Jason Weber:

Okay.

Darren Burgess:

Same practice, same practice.

Jason Weber:

yeah, okay, that's good, yeah yeah, my's good, yeah yeah. My preference in the past has been to use one.

Darren Burgess:

Yeah, I think in the ideal scenario you'd only use one, but just given timings and stuff and again I've completed Availability in CES, our doctor to make that. Ascertain which one to use in which scenario.

Jason Weber:

Ascertain which one to use in which scenario, because it is important to understand that radiology is interpretive, it's not absolute. It's not absolute Like there are certain things that gee, his leg's broken, right, okay, we get that, but you could have figured that out clinically and there are obviously big tears of hamstrings and whatever quads. But when it gets finicky, oh, we can see some tethering on the central tendon. Okay, fuck, you know, that's fine line stuff. You really want some reliability. Now I know and this is not a commentary on anybody, but I know in the States, because a lot of teams are sponsored by a medical provider, they don't get the same radiologist regularly, so they get different levels of interpretation and my experience has been that, without question, as yours would have, that you get the guys at the higher level of sport that have been around, that have seen things, that they're much just more experienced because at the end of the day, you're calling, you're interpreting a signal.

Darren Burgess:

Yeah, 100%. And I think what gets missed and that's not the right term but what the good practitioners do, and let's say, someone like a Phil Coles at Celtics. He would consider that radiology as part of the information.

Darren Burgess:

Then there's athlete pain, athlete function, objective palpation, all your clinical science, yeah for sure, All of that. So the radiology is just part of that complete picture. Then there is patient history, both from an injury point of view, patient age, importance to the team, importance to the season. All of those things should come in. If not, there is tethering. Athlete has no pain, but there's tethering. We must respect it. Therefore, athlete is out.

Jason Weber:

Yeah, I couldn't agree more. And I think in the broader discussion of are we contributing something to the way people think about this? I think, as a high performance manager, that type of space, this is not discussed enough for young guys coming through right. Same thing is, I would. And I don't know where you sit on this. I wouldn't say I'm anywhere near an expert. And I don't know where you sit on this I wouldn't say I'm anywhere near an expert, but I'm pretty handy on an MRI, like I can work my way around it because you need to be part of the discussion. You cannot be in a position where you get a doctor not trying to bully you but exclude you from the conversation because you don't know what the fuck you're looking at. Yeah, I do know what fatty deposition looks like. I do know what atrophy looks like. I know what central tendon looks like on an MRI scan.

Darren Burgess:

So they're all the thing. Because I went into a club in a position that was above the doctors and the physios. They changed their language it was a while ago Changed their language to tissue healing. It will take. Because if they said it was a grade one epimysal strain, they would say, well, you know, the player needs to be out for 14 days to allow for tissue healing to occur.

Darren Burgess:

And nobody knows tissue healing and nobody knows, certainly if it's epimysal. The tissue healing is largely and I'm being a bit general here but largely irrelevant to the function of that muscle. The muscle can function just fine, understanding that that incident might have been a shot across the bow, whatever, but, um, in order to almost, because at the system of the club that I jumped on, the physios and the doctors would have them for a period and then almost hand them over, which is the wrong way to do it. Um, but that's, that was what I inherited. And so then they would say, no, no, tissue healing, they're still with us until the tissue healing is complete. Yeah, absolutely, it's wrong, the wrong language, because you say to an athlete, tissue healing, tissue healing, and they think, okay, there's something wrong, I've ripped a muscle, so you know it's a poor choice of language external to the medical and performance department.

Jason Weber:

Mate, I'm going to just divert for a quick second, because we moved forward in our podcasting career last week and we launched the fan mails and you may have mentioned. We got a message from the great Phil Coles. You just mentioned him then. So, coles, he's jumped on. He's now listening to number 14. So he's listening to us while he's doing his old man workouts. Now I understand the old man workout more than anybody.

Darren Burgess:

Very well, very adept at the old man workout.

Jason Weber:

Yeah, we're very thankful for Colesie for getting on board and we hope he's lifting his heart out and going well over there in Boston.

Darren Burgess:

He probably needs to work on his jump shot, because he's been there long enough now to get out of the gym and work on his jump shot. But it's okay.

Jason Weber:

He's comfortably out of the gym and work on his jump shot, but that's okay, he's one of the.

Darren Burgess:

he's comfortably one of the best in the business, coles yeah.

Jason Weber:

Well, it's interesting Skill acquisition, I know, by the end of 12 years. In AFL I was a very good rehab kick, but if he put me into open field and I had to kick on the run, it just was not happening. So, yeah, well, if Colsey can't quite get to the three-point line, you know we'll forgive him that, but he should be handy from the free-for-all line, I would hope.

Darren Burgess:

Exactly Now. I went to a conference yesterday AFL-PA the National Soccer in Australia, pa, so the Australian Players Association and there was some fascinating stuff. Honestly there really was. It was a bit. It was all about player safety and a couple of things that I want your quick thoughts on. One is well a dietician, alicia at Compete, and she spoke about I might get the figures wrong, but it was one in three female athletes and one in male athletes. One in four male athletes has some form of eating or food or body image issue. Body image issue and typically, you know, in performance scenarios or performance centres, we've just done skin folds. Yep, fitness coach, level one, isac, if that.

Jason Weber:

Yeah, not me.

Darren Burgess:

And just presented horrendous data. Then we had a psychologist from Newcastle and I don't know his name, but he started off with his own story as a teenage guy growing up in Newcastle, newcastle, england, and spoke about how he couldn't fight and that was a massive issue for his dad because and his circle of friends because that's what you do in the north of England, you know, on a Friday and Saturday night and after multiple suicide attempts he went into working with athletes with addiction issues and he spoke about, you know, the signs and symptoms of addiction issues. And then I got up and spoke about. Then a lady got up and spoke about how to handle, you know, minority groups and LBGTQI.

Darren Burgess:

QI yeah, athletes. And then I got up to speak about player data issues. So my quick questions for you. One is our skin folds slash body composition. Are they gone now? Are we looking at them? Are they out?

Jason Weber:

So, again, without going into any detail, in my recent couple of weeks I was in a conversation heavily in the AFL about exactly this and I was actually told specifically you can't use skin folds anymore and you definitely can't use them on AFLW, which was a little bit of a slap in the face, but I had moved away from strictly using skin folds six or seven years ago because I started integrating skin folds with mass and looking at what I call a lean muscle index, trying to understand that and how we develop the athlete for that.

Jason Weber:

Now, I would suspect talking about body fat per se, yeah, I reckon we're looking at the end of it. When you said one in four males have body issues I'm not going to comment on females, I haven't worked directly with a female team so I can't accurately comment, although I would expect this to be higher but one in four males, I think in the latter stages of the 2000s in AFL, I think. Yeah, I know at least two coaches that had significant bulimia. They were elite players and became coaches and had that issue, and I know of a number of players that, on my watch, developed things because of the emphasis that was put on extremely low skin folds. So yeah, I think I would say he's probably accurate.

Darren Burgess:

Or she. That was a dietician talk. Yeah, she, yeah, I would probably say she's right. So right now we use Dexam. Yeah, and as of this season, only the dietician, plus or minus myself, can access that data, unless the player says yes coach or strength coach or physio or whatever. So sorry, sorry, dietician doctor and myself that's yeah, they are rules, um, or guidelines. Uh, suggested not, not mandated but, suggested by uh the ais, um, so that's, that's what we're going with and I, I think that's fair enough.

Darren Burgess:

I think we just have to be a bit careful and if it becomes a performance-related issue, then I think we can have that performance-related discussion with the athlete. But it needs to be done incredibly cautiously and with care and empathy with the dietician, the doctor and the performance director. But it's just interesting how far we've come from when you and I started. It's completely different. So if anybody, is out there working with players and taking skin files, just drop it. It's not that important, just drop it.

Darren Burgess:

It's important to have a good lifestyle and good eating habits, so please don't think I'm um um suggesting otherwise, uh. But it leads me to the other question about some of the misuse. Um, poor collection and poor analysis of data in our industry is just abhorrent, so Skinfolds is a perfect example of that and always has been Well right, mate, you bring up a great point.

Jason Weber:

I'll just finish on your Skinfold thing. I think, categorically the move for Skinfold, Dexa or anything else of that nature, that data towards the performance, medical side under your management, I think is ideal. I think it being in the hands of the coach is a nightmare. That's where I think the pressure comes, that's where I think the issues come with players, when it becomes almost a selection piece, which I have seen. I have seen that and there's no question, Are people more, are exposed or at risk of mental health issues.

Jason Weber:

On the basis of all this, now I don't know, Maybe I think the social media pressure is enormous and I think I mean I've got two kids who are now university and beyond and you've got younger ones, so we've both gone through that journey of figuring like, trying to understand social media and its role it plays in kids' lives. I think it's enormous. I think the pressure on the kids is absolutely phenomenal and I won't say not well addressed, but I think as an industry we're still learning. That would be my thing. I think people are trying, but I think we're still learning where it fits. So yeah, having some empathy and making the skinfold thing health-related more than performance. Probably to the most part. Yeah, I think so.

Darren Burgess:

Yeah, and the other issue, which is we're too late to go into it because Colesley's just about finished his workout.

Jason Weber:

So we need to wrap this up. He's just stretching down. He's just stretching down, he's just stretching down.

Darren Burgess:

We need to have a chat about the data and data rights issue because it's a big thing. I'm doing some AffairBuddy consulting work with ThiefPro and it's a big issue at the moment that we're not handling well as an industry.

Jason Weber:

Well, I've got a big history in that space, as you know so I can share that I might, even if I can figure out on the website for the podcast, I'll share a paper that I was involved in authoring which is all about that in Australia. Start that discussion, we can get there later. What I'd like to finish off on, mate, because we had another couple of bits of fan mail. Someone were just fanboying stuff, but one was a question we just do very fast because it references not directly your PhD, but it's on that path Drafting players in the AFL with non-contact ACL history. How much of a red flag is this? Are pre-draft medicals sufficient to mitigate risk? Woo, scott, you've got two minutes of your best.

Darren Burgess:

No pre-draft medicals sufficient to mitigate risk. Woo Scott, you've got two minutes of your best. No, pre-draft medicals are not at all sufficient. It's a risk, for sure, because we know that ACLs are, whether they're contact or otherwise. The risk factor remains always elevated after you have one. So, yes, it's a risk and with all of these I hate saying it depends, but with all of these, how good is the player? How big is your need for that player? Where are you drafting them? All our job is, jason is to take it to the list. Manager, draft manager, head of football football director, technical director, head coach, head of football football director, technical director, head coach. Whoever you are serving and say this person has an elevated risk to the other person that you might be drafting because of their previous history. If you're prepared to accept that risk, I'm prepared to work to reducing that risk once they come into our program.

Jason Weber:

The only problem with that is, mate. I saw and I saw this extensively for some unknown reason I got hit with quite often oh, they're not very good, we know there's a big risk, but you'll fix them. You'll be right, we'll get them in and you'll fix them. I'm like hang on, thank you for the confidence. But like, I'm not specifically saying ACL, but what I would say is that I know a particular player who was elite in the AFL, who got passed over by a number of clubs in his draft year because not of an ACL, but he had massive chondral damage and he got drafted and became an absolute rock star at the club he ended up and playing, I think in the order of 300 and some odd games.

Darren Burgess:

You're talking about Joel Selwood.

Jason Weber:

I am talking about Joel Selwood.

Darren Burgess:

I wasn't going to name him but there you go but. Joel, when I was at Port Adelaide, we drafted Travis Boat before him. Yeah, well, there's.

Jason Weber:

It's a bunch of good players. Yeah, it worked out just fine.

Darren Burgess:

Well, Friot passed on him.

Jason Weber:

I don't know who they took for him, but I don't think he was as good as Travis Boak.

Darren Burgess:

We had a choice essentially between the two, because they both came from the same area. Yeah, and that was why we went with.

Jason Weber:

Boak, for sure, but Boak has been awesome.

Darren Burgess:

Yeah, yeah.

Jason Weber:

But in that case I know Friot passed over selwood and joel became an absolute. I don't know if he's hall of fame yet, but he probably will be.

Darren Burgess:

He will be, yeah, yeah, yeah, like he become a monster, and geelong managed him beautifully so yeah, but it's risk mitigation, and probably for every joel selwood there might be five others who, correct, finish their career early with the same issue, because of whatever it is but I'll also take it back and say it is interpretive, because every ACL is not the same right.

Jason Weber:

So what damage comes along with it? Yeah, what signals do the docs see early on, like in the screening? So again you're coming down to interpretation. There's no black and white. But yeah, we appreciate the question very much and as Coles is now stop sweating, he's starting to cool down.

Darren Burgess:

He's in the sauna by now. He's gone to the sauna, yeah, yeah.

Jason Weber:

Yeah, yeah, worship that.

Darren Burgess:

Well, it's been a pleasure. There's a bit going on in the NBA and the Premier League which we'll chat about next week. We might even get a bonus podcast in at some point.

Jason Weber:

Well, we might. Nfl's got a bunch of injuries going on, although we haven't seen the Achilles thing rear its head again. But yep, we'll get another sneaky one in soon. It's been a pleasure, mate. That's all, mate. Good to chat, mate. We'll speak again soon, See you.