Why MLB athletic trainers are the key to keeping the 60-game season afloat


The Cincinnati Reds hired Geoff Head last offseason to oversee their health-and-performance team, a group of roughly 50 men and women divided into seven departments. He got the job in December, two months later than normal for that type of role. Three months after that, the sport shut down because of the coronavirus pandemic. Three months after that, on June 29, with baseball scrambling to return amid an escalating public health crisis, Head’s wife, a nurse practitioner at an at-risk clinic in Mesa, Arizona, tested positive for COVID-19 and passed the virus to the couple’s 8-month-old son.

Head, 35, found a Courtyard Marriott nearby and remained there for several days until his wife’s symptoms — frequent chills, excessive vomiting — began to subside. From there, he flew to Cincinnati, quarantined in the small apartment where he will live in isolation for the rest of the season, and then, on July 12, a little less than two weeks after baseball resumed, he finally joined the rest of his staff — a staff that was already overworked, in over its head and stretched too thin.

Head’s son quickly got over a sore throat and a raspy voice, but his wife, Zue, still hasn’t recovered her sense of smell or taste. She won’t join him in Cincinnati until her contract expires at the end of September. In the meantime, Head is worried about the possibility that she might contract the virus again in a hot-spot state, only this time passing it to either her young daughter or her aunt, who’s in her 60s, has underlying health conditions and is staying at the house to help with child care. But Head must carry on.

An entire sport — more accurately, a multibillion-dollar corporation — can’t exist this summer without the overexerted efforts of people like Head and the trainers and physicians they oversee. They’re working long hours, taking on roles they never imagined and navigating persistent uncertainty in the face of a pandemic that has claimed nearly 150,000 American lives. Over the past 19 weeks, the Reds’ health-and-performance team went through a dizzying amount of work that included accounting for hundreds of employees, reconstructing two facilities, overseeing daily testing and upholding the intricate details of an overwhelming health-and-safety protocol.

It’s only the beginning — and they’re far from alone.

“In no way, shape or form was this ever a thought on my radar that something none of us had ever been through in our lifetimes, a global pandemic of this size and scale, would impact the game of baseball in a way that none of us had ever seen before,” said Head, who spent the previous dozen years in a multitude of roles with the San Francisco Giants. “There’s no way to be fully prepared for that. There’s no crash course or formal education that any of us would have gone through specifically in these roles that we’re in to be prepared for something like this. You layer that on top of everything, and it has been an incredible challenge. Some days are incredibly stressful and trying. There’s a lot of emotions, a lot of highs and lows.”

Phase I

The seasonal flu ravaged the Reds in September of last year, prompting Head to implement a stringent wellness policy featuring many of the protocols that are now crucial to preventing the spread of COVID-19. Players exhibiting symptoms were instructed to call before reporting to the facility. Those who felt sick enough were advised to stay home; those who decided to show up were led into a quarantine room where a doctor awaited. A network of local physicians was built, and an emergency action plan was created for practically every illness.

Head called it “a crash course in preparing us for what was about to hit us in the face.”

The strict protocol helped set the tone for a three-month period when players and staff members would be on their own, relying on self-discipline to remain safe from a virus that quickly engulfed the country. Shortly after Major League Baseball canceled spring training around the middle of March, Head and his team created spreadsheets listing every Reds employee in every capacity, covering something in the neighborhood of 600 people. They divided the list, created a self-reporting questionnaire and made calls each day to ensure they were keeping tabs with everyone, including those in the Dominican Republic and Venezuela.

For more than three months, from March 12 to June 23, Head believes he averaged six to eight videoconferences per day, ranging from a few minutes to several hours. He and his staff reached out to numerous physicians and epidemiologists throughout the country to begin crafting plans of action. They were in touch with public health officials to get a heads-up on local restrictions in order to begin planning road travel. And they reached out to professional sports leagues in Europe and South Korea for insight on how they navigated COVID-19. There were daily health-and-performance calls, weekly tactical meetings and countless calls with MLB’s medical board of advisers — all with looming uncertainty over whether baseball was even possible in 2020.

The Reds’ health-and-performance team began to treat this period like an extended offseason, which meant advising players on ways to remain in shape without access to traditional gymnasiums. Head sent one video of himself filling empty gas cans with water to create 40-pound dumbbells. On another, he rolled duct tape onto the floor of his back patio to show players an easy way to make agility ladders.

In the meantime, the league and the union were involved in contentious disputes over player compensation for a season that would presumably be staged without fans. As talks dragged on, it became clear that the window between a final agreement and the beginning of a second spring training would be too short. Teams needed as much of an advance notice as possible, and so Head and his staff began to receive rough drafts of MLB’s health-and-safety plan.

They went to work as soon as possible. Travel was shut down, so Head hopped on FaceTime with local Reds employees as they walked through Great American Ball Park and potential alternate sites to work out the details. They had to designate intake and isolation rooms, plan open-air weight-training facilities and remeasure spaces to establish new occupancy limits that would reliably provide 6 feet of social distancing. Staff members drove to the Reds’ minor league affiliates in Louisville, Kentucky, and Dayton, Ohio, before settling on the corporate campus of Prasco Laboratories in Mason, Ohio, a state-of-the-art facility with two fields and major-league-quality amenities.

When the union signed off on MLB’s health-and-safety plan on June 23, the Reds had about 90% of the work done.

Phase II

Head received the initial 101-page operations manual late on a Tuesday night, near the end of an arduous day that began at 6 in the morning on the West Coast. He printed a hard copy and stayed up past midnight running through it with a yellow highlighter and a red pen. In four and a half hours, he had whittled it all down to five and a half pages of bullet points on a Word document. He emailed the cheat sheet to his staff and planned a call for the following morning. Luckily, the final copy didn’t stray too far from the earlier versions.

“I can’t imagine if we had been just taking it as downtime and kind of waiting for what the protocols were gonna look like,” Head said. “But I guess it’s like a reliever getting called into a game on short notice.”

The next version of spring training — eventually branded as “summer camp” — would begin July 1. It meant seven days of preparation. Early on, Head and his staff designated an Infection Control Prevention Coordinator (ICPC), a person who, as stated in the operations manual, “will monitor and ensure compliance with MLB-mandated health and safety protocols.” The task fell on Morgan Gregory, the Reds’ minor league strength-and-conditioning coordinator who also boasted an impressive network of epidemiologists, doctors and local government officials. Gregory would become the main point of contact for Head and Steve Baumann, the Reds’ head athletic trainer.

“This is also not something that he could’ve ever prepared for,” Head said, “but we have so much support around him that it’s not truly just his job.”

One of the team’s dietitians, Ashley Meuser, worked with the team’s chefs to come up with individualized ordering apps because buffets were no longer allowed. All of the players’ protein shakes and smoothies were individualized. Signs were placed around practically every touch point throughout the kitchen advising employees to use available sanitizers and wipes. Portable hand-washing sinks were placed next to the dugouts and within every entry point at the two sites. Trainers learned new, less invasive ways to provide daily treatment to athletes.

A lot of healthy debate went into how many members of Head’s staff would make up two of the first three tiers, which are practically the only people allowed to access facilities at the field level. MLB allows a maximum of 125 people for Tiers 1 and 2, with up to 60 of them being players and many others encompassing coaches and front-office members. Head ultimately added 20 from his staff — one ICPC, three athletic trainers, one physical therapist, two massage therapists, one Pilates instructor, two physicians, two strength-and-conditioning coaches, two team dietitians, two mental-skills coaches and four additional strength coaches and athletic trainers for the alternate site.

The approach to testing was a far more difficult dilemma.

“We had to have a lot of discussions about how much we care about our society, not just our Reds players and staff,” Head said. “Your immediate concern goes to players and staff, but there’s a national shortage on test kits. We did not want to be an organization that said, ‘Hey, we’re above any single human being on this planet and we want to commandeer and hold hostage a bunch of tests for any what-if scenarios just to protect ourselves.’ So that was challenging because there’s a lot of fear. There’s a lot of, rightfully so, people being very anxious about potentially having something and wanting to get tested then and there. The truth of the matter was that there’s people in the society, in at-risk populations in the society, that needed it so much more. So our organizational stance was paying reverence to our society more so than to ourselves.”

Phase III

Comprehensive Drug Testing, a third-party company being utilized by MLB this season, is tasked with collecting and shipping samples. But there have been instances when a symptomatic person emerged on a day when CDT was not scheduled to visit, prompting Reds trainers and physicians to put on personal protective equipment and administer tests themselves, essentially thrusting themselves into the front lines.

Results of PCR tests, administered every other day to asymptomatic players, are typically available on a master spreadsheet delivered via email. The Reds, Head said, have been receiving those results within about 36 hours, illustrating the prevalent threat of asymptomatic carriers inadvertently spreading the virus throughout a ballpark. It’s why diligence with social distancing and mask-wearing are so vital.

“Competitive advantage for organizations is how stringent, how creative you are in health-and-safety protocols,” Head said. “But then also how much buy-in and how much communication do you have from your players in that process to want to be inspired to follow those health-and-safety protocols to the T, because I think there’s some variance there around the league.”

Head woke up Tuesday morning to realize that half of the Reds’ test results were missing. It was 7 a.m., and players were scheduled to begin arriving at Great American Ball Park in about five hours for their first exhibition game against the Detroit Tigers. Head and his staff scrambled to call anybody they knew at the commissioner’s office in New York City, who would then connect with the lab in Salt Lake City to track down the missing samples and run them as a top priority.

Through this experience, the Reds’ staff learned new ways to track samples more closely. Doing so, however, required a staff member — already working up to 14 hours a day — waking up in the middle of the night on the East Coast to follow up. The hope is that MLB’s second testing lab out of Rutgers University eliminates that need.

“I think everybody’s doing as much as they can — MLB, the labs, the teams,” Head said. “It’s not on anyone’s plate. It’s just with the enormity of this task, to pull off a healthy and safe season, something none of us have ever gone through before, there’s gonna be hurdles and challenges that we all have to be in for, specifically for medical and health and performance staffs. It puts a whole lot of added stress on us.”

The Reds remain in a state of controlled chaos. Their health-and-performance staff has been setting the tone for this season since before the novel coronavirus threatened to make its way into the U.S. They have worked relentlessly for more than four months, putting in countless late nights and early mornings while consistently stretching outside of their comfort zones. Their players have bought in to the protocols. And yet — trouble always seems near, with no letup in sight.

Said Head: “It’s been an immense, immense process.”

Games, however unconventional they might seem, are the only respite. The first one came last Sunday, in the form of a run-of-the-mill intrasquad scrimmage. For a couple of hours, Head allowed himself to get lost in it. Suddenly, if only briefly, everything felt normal.

It offered hope.

“We had a home squad and a road squad, the players got to pick their lineups, we played eight innings, and it felt like real baseball,” Head said. “The players were screaming for each other and supporting each other, really getting into the competition of it, and that was a breath of like, ‘Yeah, we can do this. This is awesome.'”

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