It's the smallest injuries that cause the biggest problems in the NFL. Just ask Andre Johnson.
This story appears in the Nov. 28 "One Day, One Game" issue of ESPN The Magazine.
"What's going on? How are you feeling?"
Andre Johnson, the Texans' franchise wide receiver, is down. Midway through the second quarter, after hauling in his fourth pass of Houston's Week 4 game against the Steelers, the five-time Pro Bowler turned upfield, then pulled up lame. He collapsed to the ground, lost his helmet and clutched his right leg. Now he is rolling around in agony on the Reliant Stadium turf, holding his head in his hands and turning over onto his chest at the 37-yard line. The players around him, from both teams, slow down. Then they just stop and watch.
"Talk to me, Andre."
In a flash, Johnson is no longer alone. Head athletic trainer Geoff Kaplan is there. As happens on every play, the snap of the ball had launched his eyes into a scan of the field. They never follow the ball. Rarely do they look above the players' belt lines. When everyone else is turned to track a run or a reception, Kaplan remains focused on the line of scrimmage, making sure all of the timbered linemen get up off the ground. He watches knees and ankles. He looks for drooped shoulders, unusually heavy breathing -- any sign of injury. On this play, Kaplan's eyes had whipped toward Johnson just as the 6'3", 226-pounder crumpled without being hit.
"Take a deep breath. What does it feel like?"
Silence has enveloped the stadium now, and Kaplan's voice is the only one Johnson hears. It has a comforting tone, finely tuned over 300 games and countless moments like this one. The trainer places his hand along the back of the player's ailing right leg.
"Andre, tell me what you feel."
Johnson's voice is normally self-assured, an almost sleepy baritone. But Kaplan notices signs of panic -- a pitch that's an octave higher and disbelieving eyes that won't stop looking at the leg.
"Look at me, bud. Talk to me."
The 71,585 fans in attendance are convinced it's a knee injury. And for a split second, as he fell to the ground, so was Johnson. But almost instantly Kaplan knows it is not. He runs his hand over the knee and the check reveals that everything is where it's supposed to be. As Johnson rolls over and sits up, he looks into the trainer's eyes and knows that yes, he's hurt, but no, it's not devastating.
Suddenly the fear is replaced by reason. The chaos of the moment slows enough to open his mind to self-analysis. Johnson talks through the catch, the landing, the pop he felt in the center of his right thigh and the tightness he still feels. Kaplan looks to the other two men on the scene, fellow trainer Roland Ramirez and Dr. Walter Lowe, one of 10 physicians on the Texans' sideline for every game. They've done the same spot evaluation and heard Johnson's description. They nod to Kaplan to indicate they're all on the same page. It's in the hamstring: Maybe a pull, but the fact that he collapsed the way he did indicates something more severe, likely a muscle strain or perhaps even a tear.
Under his own power, Johnson stands, albeit slowly. He walks to the sideline with a slight limp, head held up in an effort to look unconcerned, with a glance toward the giant video screen. He passes through a parting wall of teammates, all of whom say nothing; he bypasses the bench for the end zone tunnel and the training room.
For a second, Kaplan considers checking out Johnson on the sideline examination table, but the scene there is borderline bedlam. Team execs, reporters, photographers and everybody else with on-field credentials have already crowded around for one show there today -- back in the first quarter when running back Ben Tate received treatment for a groin pull. "Thank God," a member of the security staff says as he watches Johnson walk away. "No offense to Tate, but if I had to pull people back from bothering him, then I'd have to go John Cena on the mob of looky-loos that would pile in here for Andre."
In the training room, Johnson is stretched out on a massive wooden exam table. In many ways, the Reliant Stadium sports medicine area is cutting-edge, complete with an X-ray machine and the chlorine smell of a YMCA's worth of pools that feature contrasting temperatures, resistance currents and whirlpools. There are volumes of sports medicine research journals along with mountains of digital data on each player. But also lining the shelves throughout the rectangular concrete room where Johnson now lies is an inventory of items that can be found in any high school training room: thousands of rolls of athletic tape, an anatomy chart and jars of good ole stinky Atomic Balm.
Lowe, who's followed Johnson off the field, begins a deeper orthopedic examination. Using two thumbs to press down into the thigh, he feels for tension, for heat that might indicate bleeding, for gaps in the muscle that would suggest tearing or for tingling that might signify nerve damage. Now lying on his back, Johnson has his leg lifted, stretched straight up as high as it can go, searching for its limit. Sitting up, legs dangling over the edge, he is asked to resist as doctors press down on his shin to test strength. Every step of the way is punctuated with: "How does that feel? Is it tight? Does it tingle?"
There's not a lot of trust going on in this league, but you trust trainers with your body.” -- Texans running back Arian Foster
Every detail is relayed to Kaplan back on the sideline, via radio earpiece. No one wants to ask him about Johnson, for fear of what the answer might be. Finally an assistant coach breaks the silence. "Hamstring," Kaplan responds, eyes still fixed ahead. "He'll be all right."
"F'n hammy," the coach says as he walks away.
Welcome to the world of the NFL trainer. It is a never-ending parade of the wounded, sometimes covered in blood but more frequently wrapped in mystery. Here, the most cumbersome work can be found not in the breaks and tears but among the dings and deep bruises. On any given NFL weekend all 32 teams will have, on average, half a dozen players sitting out because of injuries. Early in the season it might be three or four, and by Week 17 it's eight or nine. The vast majority of those injuries are like Johnson's. Nagging and tedious, left to be described by the most confusing of all lists, the "probable/questionable/doubtful/out" NFL injury report.
For those trying to rehab their way through that scale, team trainers preach the benefits of taking one's time in the most macho job imaginable. It's a hard sell, light-years from the old tape-an-aspirin-to-it, walk-it-off approach that still permeates many corners of the league. But because Kaplan pushes patience, and because the front office and coaching staff allow him to, he keeps the players at ease and continues to cement the trust between the locker room and the training room.
"All you want to do is get back out there," says Arian Foster, who missed Week 1 and the second half of Week 2 with a hamstring strain similar to Johnson's. People screamed for his return in Week 3, but Kaplan and the Texans chose to sit him out an extra week. He was cleared just four days before the Steelers game and responded with 155 yards and a touchdown. In the next five weeks, Foster rushed for 100-plus yards three times and had two 100-plus-yard receiving games. As Foster explains it: "When Geoff looks you in the eye and says, 'Tell me how you feel,' you realize that whatever he is saying you need to do is what you need to do. There's not a lot of trust going on in this league, but you trust them with your body. The second that Andre was hurt, he knew that trust was there. Just like I did."
Kaplan learned that philosophy early in his nearly 20-year career. He started full time with the Houston Oilers in 1995 before moving east with the team to Tennessee. Along the way, Eddie George, Bruce Matthews, Frank Wycheck and Steve McNair -- four legendary locker room presences -- taught Kaplan the importance of a strong bond between the man who fixes bodies and the men who occupy them.
"McNair and I kind of grew up together," says Kaplan of the QB icon. "He took football very seriously, and early on he set the no-BS tone with me. He promised honesty about feedback, and I promised to be honest with him about his condition. They all taught me the importance of preventive maintenance. They stayed out ahead of the pounding with hard work. Those lessons are still with me."
Kaplan constantly calls on that approach with his staff. "These athletes know their bodies better than anyone, and they know when something's wrong," he says. "But you have to ask, and you have to listen."
In return, the athletes must listen to the trainers and the doctors, even if they don't like what they hear. Just ask Johnson.
The X-rays performed on Johnson in the Reliant training room were encouraging; they revealed no damage to bones or ligaments. So he returned to the sideline of the Steelers game to support his teammates, all the while knowing that the next morning he'd be chaperoned to the hospital by a member of Kaplan's staff for an MRI. As the final horn sounded after the 17-10 win, he followed his team out of the tunnel, stone-faced. "Andre!" a woman shouted, hanging over the railing. "We need you back!"
"Don't worry," the receiver replied without cracking a smile. "This won't take long."
Less than 48 hours later, Johnson found himself on another table, once again facedown. The MRI identified a hamstring strain, and as Foster was nearly two months earlier, Johnson is ordered to begin platelet-rich plasma therapy. PRP is an injection of blood plasma that contains huge amounts of bioactive proteins, created by using a small amount of Johnson's own blood. It won't directly repair the injury, but it will prevent excessive scar tissue from building up around the injury as it heals.
Two days later, on Wednesday, Kaplan presents Johnson with a rehabilitation and recovery plan, beginning with flexibility and coordination exercises. And even though Johnson was hopeful that he could return in two to three weeks, the player's response is typical. "Time's wasting," Johnson recalls saying. "Let's get on with it."
One week goes by. Then two. Then three. Johnson graduates to work with his position coach, replicating the motions of a game. Eventually, perhaps even on a game morning, he will run those drills in front of Kaplan and the coaches three hours before kickoff, praying to be activated. "That's the hardest part," Johnson says. "When you feel like you are so close, but then there's another step added. Or you get paranoid about every little tug or tightness you feel. It wears your mind down. But they keep pushing you, reminding you of the ultimate goal."
All of the above happens with the openness of a Pentagon special forces briefing. Through Week 10, Johnson still hasn't played. That leads to media impatience, Internet speculation and random fans pestering Kaplan with questions at the grocery store. "It is unusual, I suppose, that so much of how the NFL works is built around keeping secrets," Kaplan says, two hours after the Steelers game as he bangs out the official in-house injury report at his desk. His phones are already ringing with people wanting updates on Johnson. He responds with yes, no or a grunt, wary of revealing information to the writer and the photographer sitting in his office.
Then he stands, headed to give his bosses an update on the condition of the franchise player. But before hitting the lights, he turns around and makes direct eye contact with his guests.
"How you feeling? You good?"
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ESPN The Magazine: November 28, 2011