In this part of the interview series, sports massage expert Don Butnzer takes some time to answer questions. As you will read, Don has a unique background in therapy treating some of the world’s best track and field athletes, but he also was part of the team of people who helps organizes therapy at track meets such as the Prefontaine Classic and the 2012 Olympic Trials.
Don has vast experience working in championship environments, including
- 2003-2014 Prefontaine Classic (Massage Team Captain from 2008-2014)
- 2007-2008 Road To Eugene High Performance Meet
- 2008 USATF Olympic Trials
- 2009 and 2011 USATF Outdoor National Championships Massage Team Captain
- 2009 IAAF World Championships
- 2012 USATF Olympic Trials Massage Team Captain
- 2013 Jamaican Track and Field National Championships
Don, your have quite the resume of working big meets. What makes a therapist sought out?
I think sports therapists get repeatedly sought out for two main reasons. Of course first and foremost, a therapist would be sought out for quality work, but another very important factor is the therapist's ability to build a solid relationship with athletes. Those appropriate professional, yet also personal, relationships have played a large role in athletes seeking continued care from me and some of my colleagues in the sports massage world.
In what ways are you different from other therapists, and who have been some of your teachers?
I consider myself very fortunate to have had some exceptional teachers and mentors along the way. This started clear back in massage school with my sports massage teacher, Jon Hart. He focused on structural balancing and Muscle Energy Techniques, which set an amazing foundation for me. After that, I sought out instructors and classes that also focused on structural balancing and neuromuscular techniques. From there I sought a progression that had a dynamic focus - basically putting the body in motion effectively for enhanced performance, but still concentrating on structural balance.
I also feel blessed that my hands really tune in to fascial slings and the body's tensegrity. I think lots of my soft tissue work enhances the body's ability to load and fire in a manner that can improve performance.
I also use kinesiology taping for both balance and power.
You’ve done sports massage work for a while. Thinking back to your early days and comparing to now, what were some things you did back then that you would do differently now?
I had a moment early in my sports massage career that absolutely stands out as a real learning opportunity. I was working on an Olympic 1500M runner and my mentor at the time was walking by and I asked him if what I was doing was correct and the right pace. Here's the thing with that: if I wasn't confident in what I was doing, I shouldn't be doing it - especially pre-event with an athlete of that caliber. Additionally, by asking in front of the athlete, I surely leave some doubt in the mind of the athlete. That makes me cringe now! I always tell new therapists on my teams to be confident! Those athletes need to focus on their upcoming competition and don't need doubts or worry creeping in to their mindset. If you aren't confident in what you're doing there, direct them to a therapist who has the right experience.
What are some of your key principles you use in treatments?
Treatments are geared for the condition the athlete is in, but also for where the athlete is at in training or competition, which always needs to be considered. Pre-event, I look to make sure myofascia feels clean and ready to perform and that the nervous system is on board and ready to perform at the highest possible level. Inter-event is all about lymphatics and a gentle focus on cleaning up adhesions. Post-event offers a lot more freedom to work at flushing out the tissues, realigning structural imbalances that may have occurred as a result of the event, clearing adhesions in the soft tissues, and general deep tissue work as appropriate. We're looking to enhance recovery.
What type of assessments or exams do you do at the start of your sessions, and how does this change when you are preparing athletes in a race environment?
Assessments and exams depend on the athlete's needs, so they vary. Commonly I will do an assessment of structural balance, both static and dynamic, and then palpate muscle and fascial health. Sometimes in a race environment I may not have the luxury of a thorough exam or assessment, so the athlete’s initial report will dictate how we proceed. The assessment will be quick and focused just on the complaint. Hopefully, though, in an elite race environment the athlete is healthy and basically ready to compete - otherwise we really have bigger problems anyway!
How do you measure effectiveness of a session?
Effectiveness is measured by how well we obtain the treatment goals initially discussed. Frequently in a sports massage setting, you may see an athlete only once and not have the opportunity for a follow-up. In this case your feedback may be just what the athlete tells you right when they get up off your table. This reinforces how important good communication is from the very start.
One piece of advice I would give new sports massage therapists when it comes to this topic, is that you are not competing for the athlete. You can't run the race for them - so a race that doesn't go super successfully may be due to many factors. The massage isn't the only factor. Likewise, an athlete who gives a stellar performance has put a lot of training in and the massages leading up to the event probably were not the main factor in the success. Keep your understanding of your role accurate. We do better when we work to help the athlete the very best we can, and keep our egos at bay.
What do you feel is the biggest thing the athletes want and or expect from a therapy session?
Of course the athlete wants the session to optimize performance. That's a given. But athletes also really want the therapist to listen to them and treat accordingly. I've spoken with a lot of athletes who have shared frustration that the therapist just seemed to go through a routine and didn't spend much time focusing on the issue the athlete initially reported.
You’ve worked at many championship events. How much time do you typically spend on athletes? Given there might be various scenarios, can you run through a quick example of a few to get a sense for what might happen?
The amount of time I have with athletes totally varies at these events. Sometimes, when we get slammed, the sessions may have to be quick - like 20 minutes or less. Whenever possible, I try to give the athlete however much time they need for our treatment goals. I've spent three hours in a post-event session with an athlete.
A newer therapist may not spend quite as much time on an athlete if they haven't already built a relationship.
If the session is a couple days before the competition, which is a real possibility for these major elite events because we start treatments several days before competition starts, the sessions will likely be longer. We might treat for minor dysfunctions or imbalances and spend an hour or more on treatment and then spend some time developing an integration plan and continued care plan that would take us all the way through the event.
If the session is pre-event, like during the athlete's warm-up, it may be a very quick check of soft-tissues that would take 5 or 10 minutes. I may also do this very dynamic stretching routine as part of the athlete's warm-up that takes about 5 to 7 minutes.
So far in the interviews I’ve done, a common theme has been that each therapist is known for their own style of work. Athletes/agents/coaches seek them out because they trust and know how that therapist works. What would you say you are known for?
I'm definitely known for that dynamic stretching routine I just mentioned. I do this with sprinters and hurdlers that I've developed relationships with and that have practiced this routine with me. Some of the feedback I've also heard is that I work at appropriate depths for the timing of the treatment and that I'm thorough, so the athletes have confidence in the work. I personally think that having a good feel for fascial slings is a real gift in the sports massage realm for me.
You worked a lot with Muna Lee. Being you two lived far apart, how often would you work with her?
Muna is one of my all-time favorite athletes I've had the pleasure of working with. At this point, I consider her a family friend! The fact that we did live so far apart limited our chances to keep a consistent treatment routine going, but we found ways to make it work. She was very good at updating me on any issues that came up. We had lots of phone consults. Also, before big events, we would try to coordinate a week or two together leading up to the event. Occasionally, she would stay at my house or I would travel to her and we could get a lot of focused work done to have her prepped for the competition. Then we would travel to the event site and keep the work going through the competition.
You traveled to races with her quite a bit. Would you mind taking us through what a few days might look like leading up to a major championship?
My favorite event with her was probably the 2008 Olympic Trials. We got to begin work nearly two weeks before the event. This was going to be a tough competition for her because she was running both the 100 and 200. We focused on orthopedic issues consistently until 3 days before the competition rounds started. What was great about this was that it was a team effort with several people. Two of the best bodyworkers I've ever worked with, Dr. Rich Gorman, who is a sports chiropractor, and Robyn Pester, who very well could be the best PT in the world and is a kinetic chain genius, worked with us in these days leading up to the competition. By event time, Muna was dang near perfect!
In the couple days before competition, we began to gear sessions to mirror what we would do at the event. We would go through our pre-event routine before her practices so that we would have them down so well that we wouldn't even need to talk to go through it on competition day. This would allow her to just mentally focus with confidence right before she competed. Unless she needed to let me know something didn't feel perfect, we just did our pre-event routine with just eye contact and hand taps when I needed her to fire a muscle. Obviously, that's not a typical sports massage situation, but when you have the ability to really work full time with an athlete, those types of relationships can be developed.
After her practices on those couple days before the competition, I would do a quick check of the health of the tissues to make sure everything still felt clean. In the evenings, I would do a quick, light massage again to see that things still felt smooth - checking to make sure there was no congestion in the tissues and that I didn't feel any myofascial adhesions.
The other thing that happened during this time leading up to the competition was the creation of a game plan to make sure things ran smoothly with her coach's needs during the event. There are things the coach needs from her at specific times, and I needed to make sure I didn't interfere with that. Inter-event concerns, such as nutrition and recovery, especially on days with multiple heats, had to be considered. This may not be something a newer therapist may even know to consider.
Of course, things rarely go as planned once competition starts and you have to be ready to adjust on the fly. In Muna's case at these trials, there were definitely some orthopedic issues that arose as a result of the grueling competition schedule she had. We stayed strong in our communication as a team and did some amazing work to help get her through and qualified for the Olympics in both events! It was truly a team effort.
What advice would you give to a younger sports massage therapist who is starting out?
Volunteer at some local community sports events and get your hands on athletes. If you can, build relationships with local athletes and begin to work with them in all phases of training and competition.
You definitely need to learn the sport you are working with. It is crucial to understand a sport's demands on the athlete.
And of course, take as many classes as you can, and get yourself around the experts in the field.
I’d like to focus a little bit on your work organizing therapy at meets. You have done a lot with USATF coordinating medical coverage at major events, like the Olympic Trials in Eugene in 2012. How many people are on this team and in what fields?
I'm glad you are asking about the administrative side of this, because it is an important component of sports massage. I don't think many therapists know how much behind-the-scenes effort goes into organizing and performing events like these. It's a lot of work! For the 2012 Trials, I had over 50 volunteer therapists. I really tried to recruit the best sports massage therapists I could hunt down. We made sure we had a variety of specialties, including MET and ART experts, CKTPs, FAT Tool experts, and others. We wanted to make sure we could accommodate nearly any athlete request that may come in.
What criteria are used for selecting these individuals?
The therapists at Trials were a very experienced group. They needed to have solid sports massage training and experience. A few therapists had a little less experience and we made sure we placed them in roles that had good support around them so they could refer appropriately. For example, many of the therapists did not have extensive training in kinesiology taping, so we made sure at least one person on each shift was proficient so taping could be utilized.
How does your team of therapists work with athletes at these types of events, compared to athletes who have their own therapists who are given credentials?
At the Trials, we had massage treatments available at two sites, the competition venue and the athlete hotel. We would offer treatments at specific times at each venue and any competing athlete was able to get work from our team at these sites. Athletes who bring their own therapist to this event had to obtain a credential for their therapist if they wanted to have them in the competition venue. There, we had a separate area available for those personal therapists to set up.
Taking this further, given you have so many chiropractors and so many massage therapists, how are athletes assigned to therapists? Is there a specific process? Or as simple as a “next in line” type arrangement?
When an athlete would come to us for treatment, if they didn't request a specific therapist, then they would be taken to a therapist who was free at the time. First come, first served. We had an intake area that handled athlete flow, which helped a lot. As you can imagine, with an event as big as the Olympic Trials, we were very busy, so there wasn't a lot of down time, except early in the morning. We tried to staff a large enough team all the time so that there wasn't much wait time for an athlete to be seen. Now, athletes requesting specific therapists would sometimes have to wait until that particular therapist was free and that any athlete waiting longer than them was seen first if their requested therapist became available.
Sometimes a particular therapist and chiropractor will develop a rapport and be working with an athlete as a team, in which case we just let them handle the athlete as they need to.
As a side note worth mentioning, we've found that two massage therapists for each chiropractor is a good rule of thumb for practitioner ratio.
Are there any events coming up soon you might be found at? Are you teaching any courses? Working any upcoming meets?
With this year not having a World Championships, it is a slower year for me. I have some local events I will be involved with, but that's about it for sports massage. I am talking with a couple athletes about traveling with them as personal medical for 2015 for Worlds and on into the Rio Olympics and then 2017 Worlds. Nothing definite yet.
As far as classes go, I suspect that Andy Miller, who you interviewed a couple weeks ago, and I may offer some FAT Tool training classes. They're a great tool for any sports massage therapist to consider.
Is there a website where people can reach you?
You can find me at www.facebook.com/don.butzner
Don, thank you so much for taking the time to answer some questions. The information shared is a gold mine! All the best to you!