Pros learn to work out on the road

A hectic travel schedule through airports across the country could easily get in the way of professional golfers staying healthy and fit.

So to avoid injuries during the grind that is the PGA Tour schedule, DePuy Mitek's mobile fitness and therapy centers serve as a mobile rehab facility where players can receive treatment for injuries and also act as an on-site fitness trailer where players can conduct a complete workout regimen.

The expandable trailers that travel the country are approximately 800 square feet and can accommodate multiple players at one time. They are open for business from as early as 5 a.m. to roughly 7 p.m. to allow players the option to come in before or after tee times, or sometimes both.

The therapy trailer has several Hi-Lo tables (high-tech treatment tables that move up and down and can be angled to tilt the head or feet) on which golfers can receive manual (hands-on) treatment. There is also some floor space and mats for stretching and exercise, along with various resistive bands, weights and other similar tools.

Cabinets contain bandages, gauze, tape, wraps and other products that are necessary for all of the blisters and cuts golfers sustain. The trailer also houses equipment such as ultrasound and electrical stimulation units, but the majority of treatment involves manual therapy and exercise.

This trailer is staffed by two physical therapists and a chiropractor each week. Players can come to the trailer at any time to seek advice related to a new injury or ailment, or for follow-up treatment for a current condition. If a golfer sustains a new injury, he is put through a complete evaluation and then a course of treatment is prescribed. If additional tests such as X-rays or MRIs are needed, or if prescribed medication is necessary, there are physicians on call in each city who can assist in those matters.

The treatment doesn't stop with the injury aspect alone. The fitness trailer, staffed by athletic trainers and strength and conditioning specialists, provides a setting in which golfers can bridge the gap between recovering from injury and returning to peak performance.

Inside the fitness trailer is an array of cardiovascular equipment such as treadmills, elliptical machines and stationary bikes along with a selection of weights -- both free weights and resistive training stations -- as well as exercise balls, balance equipment and other apparatus.

The staff in the fitness trailer works in concert with the rehab professionals to help create tailor-made exercise programs for each player coming off an injury. These programs are designed to return golfers to competitive form while hopefully preventing recurrence of a similar problem. The importance of educating players that it is not enough just to get past the painful episode of an injury, but that there is more work to be done to return to a high-level function, cannot be understated.

In a game in which musculoskeletal aches and pains associated with repetition and overuse are the norm, this traveling team of health care providers and fitness specialists is a welcome presence.

U.S. Open winner Jim Furyk is a regular in both mobile trailers.

"I use the workout gym to warm up in the morning, stretch, get ready for my rounds," he said. "If anything's bothering me, I go see the chiro or the PTs in the other trailer."

Golfers on the tour do not need to have an injury to take advantage of the expertise and equipment available in the trailers. They can request a personal conditioning program designed just for them.

The staff performs a functional assessment looking at strength, range of motion, agility and other variables to assist the player in determining where certain imbalances exist that might ultimately be affecting his game. Golf is a very one-side dominant sport that involves a powerful, torque-inducing repetitive motion (swinging a club) which can lead to muscle imbalances, both in terms of strength and flexibility.

Additionally, the physical frames of golfers can vary greatly, which might predispose different athletes, depending on their shape and size, to different types of injuries. Participation in a customized, structured exercise program can assist in overcoming some of these challenges and keep a golfer healthier year-round.

For those who simply want a place to exercise while on the road without having to find a new gym in every city, the fitness trailers provide all the space and equipment necessary for a complete workout. Not only is the equipment state-of-the-art, the trailers are newly refurbished, air-conditioned and for the players only.

In addition to the benefit of being in a comfortable and relaxed atmosphere away from the potential distractions of a crowd, the players have access to the professional staff for any questions that might arise during their workouts. There are even workout clothes and shoes available in the trailers, eliminating any excuse for missing a session.

The confidence the players have in the staff is immediately obvious. On my tour of the therapy trailer during the Memorial Tournament, Brad Faxon happened to stop in for his daily regimen. He offered up unsolicited high praise for all of the professionals who staff both trailers.

"They're the best, they're just the best," he said over and over.

Faxon is clearly committed to the concept of exercising regularly while on tour. He said he makes use of the trainers and therapists every day he is at a tournament and has even collaborated with the staff in a series of fitness tip videos sponsored by DePuy Mitek.

In the weekly videos, which began in May and run through October, Faxon and selected professional staff demonstrate various exercises targeted at all levels of golfers who would like to stay in shape and hopefully prevent injury.

Those who are in the business of health care and physical fitness are well aware of the benefits of regular exercise. The exciting part for the folks who staff the trailers is that it seems to be catching on among the golfers on tour. Visiting the trailers for consultation or even just to exercise is voluntary, but the number of golfers taking advantage of the opportunity seems to be on the rise.

Strength and conditioning coordinator Scott Riehl, who has traveled with the tour for 10 years, sees a big increase in utilization over that time by tour golfers.

"Ten years ago we saw about 20 to 30 percent of the field," Riehl said. "Now it's more like 70 to 75 percent, maybe higher."

So why the increase?

"Awareness," Riehl said. "A more athletic golfer [is a] more successful golfer."

Of course the potential for increased earnings that comes with success is a motivator.

"And," added Riehl, "these guys are competitive."

If being more fit provides an edge, then they want in.

Furyk agreed.

"There's been a fitness boom on our tour the last 10 years," Furyk said. "It's been pretty amazing. Guys are in better shape. They're better athletically trained for our sport. And it's affected our tour positively as far as the depth and the level of play."

By making these trailers and the professionals who staff them easily accessible to the golfers, it encourages more regular participation in these programs. If the trailers did not exist, golfers who are on the road roughly 150 days a year would be forced to seek out new facilities -- and, more significantly, different health care and fitness professionals -- at every stop.

The players would be less inclined to seek out the services, not only because of inconvenience, but because of the unknown element of who would be providing these services. The players develop relationships with the professionals who care for them and develop confidence in their abilities as they work with them over time.

Communication among the staff helps ensure consistency of care. All evaluative findings, treatment programs and fitness routines are documented in a computer system and verbal communication among the members of the team is ongoing.

When asked about the value of having these trailers and their staff on tour, Furyk's response focused on the team approach.

"They know each other real well," Furyk said. "They make a great team. No one has an ego. No one knows more than the other. And they communicate real well together, which I like.

"If I go in there and I'm struggling with my back or my wrist or whatever it may be, they all talk among each other ... It's nice to have a rapport with these guys and see them week in and week out."

Just as improving healthy behaviors and fitness in the general population is a work in progress, so it is among professional golfers, as well. I was surprised to learn during my time at the Memorial that golfers can still smoke while walking the course during play. Perhaps even more surprising was finding that some of them still do.

By and large, the golf world does seem to be taking note that working out can actually enhance performance and prevent injury, ultimately enabling an individual to prolong his career. Furyk, who has been challenged by various injuries at times, is committed to a regular maintenance regimen.

"I'm hoping it will extend the length of my career, and I think it already has to a certain extent," he said.

Whereas lifting weights was once avoided as many golfers thought it would make them "too big" and hurt their swing, they are now finding that they can avoid bulk but improve power by doing the right type of training.

Limited flexibility, once a foregone conclusion among golfers, is now something that can be addressed through specific types of exercise components. Cardiovascular training, long thought to be unnecessary for a four- to five-hour golf round, is now viewed as not only positive for one's overall health, but as favorable for increasing endurance on the golf course.

The next generation of golfers is starting to adopt this type of training at an earlier point in their careers. Riehl said that the younger golfers are now emerging from college with their own conditioning, something that simply did not exist even 10 years ago.

It's safe to say that no sport is completely free of injury; it is a natural by-product of athletic activity from weekend warrior to professional athlete. Minimizing injury, however, is still a worthwhile goal, as is optimizing health and performance.

All types of athletes are spending more and more time training outside of their specific sport for just these reasons. The PGA Tour seems to have subscribed to this philosophy by making these mobile facilities and staff readily available to players. And the players seem to be catching on.

Stephania Bell is a physical therapist who is a Board Certified Orthopedic Clinical Specialist and a Certified Strength and Conditioning Specialist. She is a clinician, author and teacher with extensive experience in the area of orthopedic manual therapy and sports medicine.