# Dr. Keith Meister interview transcript

## Dr. Keith Meister interview transcript

Talk about the functions that are generally performed at the Medical Center of Arlington clinic.

I suppose I should start at the beginning. I was brought here about a year and a half ago by the Rangers to take care of the ballclub. I had been the team physician at the University of Florida for about 10 1/2, almost 11 years. The Rangers called and asked if I'd be interested in taking care of the club, and I said [it is] certainly something worth taking a look at. I came out probably five, six trips back and forth between Florida and here. I finally realized it wasn't just a good opportunity to take care of a Major League baseball team, but it was also a very, very strong opportunity and potentially great opportunity to build a very large national sports medicine-type center. My interests had been in baseball, but [also] in many other sports, in not only treating but also preventing injury. MCA hospital got involved in the discussions and obviously arranged for a medical-care agreement with the ball club after I had already arranged to come out here and take care of the club. I got involved with the hospital, and they shared my vision, which was to build a large sports medicine rehabilitation center here at the hospital. So that's where we are now -- we opened up the center about three weeks ago. It's an 11,000-square foot center right across the hall from my office here, which works out very conveniently. My head therapist I brought in with me from Florida and I brought several other top-notch physical therapists and athletic trainers with me as well to accomplish the goals we have set out to accomplish, and that is, as I have said, to build a well-known, well-recognized, high-quality sports performance, physical therapy rehabilitation center. We're moving forward; so far, so good.

Talk about the clientele -- will only professional athletes use the facility?

No, not at all, and I always say any time you're building a practice, it's like building a business -- you really have to take care of your own backyard first. The professional athletes that you see in a center like this are really a small percentage of who you actually end up taking care of. Most of the folks that we actually see are the weekend warriors -- our high school, our collegiate athletes. Obviously not an insignificant number of professional athletes, but each and every one of those other groups deserve the same kind of care, the same quality of care, same attention that our professional athletes get and receive. I always say, for the high school kid, the 16-year-old kid with a blown-out knee, for that kid, that instant in time and that prom is just as important as it is to a professional athlete trying to make it back on the field for an evening game, or a Saturday football game in terms of college, or a Sunday game in the NFL. To that individual, that's the most important and most critical issue in his life at that point, so he deserves the same kind of care and the same focus, same attention. That's what we strive to achieve here.

What sort of facilities or capabilities do you have here that make this a good place for someone like that to come?

Personnel, obviously, is a No. 1. It doesn't matter what the quality of the building is, the quality of the ceilings, floors or the equipment. If you don't have the right people to run it, then it really doesn't matter. You can invest all of the money that you might possibly conceive in building a facility like that, or certainly building an office like this, but if you don't have the people -- that's the most important, that's the most critical ingredient. Certainly, I think we have that here. I've brought in some folks that I worked with for many, many years at the university. They've had experience with taking care of athletes at all levels, and certainly the highest level in every sport, not just baseball, not just football, not just basketball. Even across the board with women's athletics, which is just absolutely huge now. So that's most important, and then the hospital has provided us with the tools to be able to accomplish this. We've got a very, very nice facility next door. We've got state-of-the-art equipment -- workout equipment, training equipment -- and we have people that know how to use it. Those are really the two main ingredients that we need to be successful.

What are some of the things one might see touring the facility? What are some of the machines or some of the areas that might have been used for specific injuries?

Some of the equipment is equipment that people haven't even seen or heard about yet. It's really state-of-the-art equipment that we are testing in our facility for some of the cutting-edge companies out there. Some of the strength-training equipment and more of the newer equipment we're seeing out there now is not just focused on strength and not just focused on range of motion, but is working muscle and muscle groups through a functional arc and a functional range of motion, which is going to really add to our ability to help these individuals recover maximally at perhaps even a quicker pace. Some of those things we can obviously show you if we take a look next door. Some of the areas we have designated are very functional work areas. We have an Astroturf area that is about 68 feet [from] wall to wall. In that area, we can actually have guys throwing in mound simulation. We have not yet done this, but we have some high-speed cameras coming and some force plates so that we can do some state-of-the-art video analysis and even some initial research out of this facility although we are planning on a different facility to continue with some significant research in athletics. The floor is specially designed in there, what we call a sport floor, that is specially cushioned and almost the entire floor in facility can be used to do balance and agility kind of work as people get more into functional activity throughout the course of their rehabilitation from injury. And lastly, I think a very important focus of what we are doing over there is injury prevention. It's much easier, as I always say, to prevent injury than it is to bring somebody back once they're already injured to cure them. That's a critical part of what we're doing. We're running some large programs this summer to begin to start to delve into those areas a little bit more aggressively.

Talk about programs that your clinic can do in general, and specifically for the Rangers, which focus on injury prevention.

We've got some speed and agility programs that we're starting this summer. We're actually preparing a football-sized field right across from the hospital here -- it's going to be close to 100 yards. We're going to be running some speed and agility sports performance programs. They are actually eight-week programs. We run a combine-type program the first week; we do a lot of testing and jumping and speed, and then we run our program for six weeks. It's three workouts a week, very supervised, very concentrated, for a six-week period of time, and then we do a re-testing in the eighth week to see what kind of gains have been made. On average, we see some significant gains, particularly in our high school and collegiate athletes, and that's really where our initial focus is going to be. The other area, which is a very specific interest of mine, has been the female knee. Anterior crucial ligament injuries in the female athlete has been an absolutely epidemic problem over the past 10 to 15 years as women have gotten more heavily involved in some of the high-risk sports -- the jumping, landing, cutting types of sports. For instance, on an NCAA level, if we just look at women's basketball, we look at injury rates 10 times that of males. It truly can be a devastating problem. You lose two or three individuals on a particular roster, a 12- or 14-individual roster in a season, and you've lost 20 to 25 percent of your roster. So it's a problem we need to find solution to. Obviously, we can fix it, but it's going to be much nicer if we can solve the problem before they become injured. We are running some ACL prevention programs. Specifically, these programs are designed to teach these female athletes to jump and cut and run and pivot better, to help avoid these types of injuries. There are some training techniques that have been proven thus far that have had some effect on reduction of the incidence of tears to the anterior crucial ligament in women.

Recently, you and the hospital contributed to a program aimed at the younger kids, the Showalter Fitness Walk. What interest do you have in injury prevention at the elementary school ages?

Well you can actually start a lot of this stuff at very, very young ages -- in the elementary school ages. A lot of the jump programs we talk about utilizing with our female athletes that are perhaps a little bit older, more into their high school years, can be initiated at these younger ages. Specifically, what you are talking about -- the fitness program the Rangers have endorsed and MCA has endorsed -- is a program that probably had its impetus from Angela Showalter. She's an absolute fitness guru, and she's in as good of shape as anybody I've seen out there these days. She really wants to try and affect the overall health of kids at a very, very young age, and that's again something that has drawn a lot of media attention lately -- the health of America and the obesity that we are seeing now even in our younger and younger age groups. That's something we really need to change; we need to alter lifestyles in these kids at younger ages to help try and reverse the trend that we're seeing. If we can stop it now, then some of these long-term health problems that we see in our adult-age populations, we perhaps can significantly have an impact on.

Talk about how you work with Fernando Montes in preventing injury with the guys on the team.

One of the things, I think, that makes us very, very unique as a club and a medical staff is that we've got just a fantastic working relationship. Myself; Jamie Reed, our head trainer; Kevin Harmon, our assistant trainer [and] Fernando Montes, whom you mentioned, our head of strength and conditioning, have a very, very good relationship. Injuries are discussed, and prevention of injuries are discussed quite often. We are all intellectually stimulated about those things, and Fernando is probably one of the most cutting-edge people that I've met in athletics with respect with trying to think a little bit out of the box, in trying to develop different ways to evaluate athletes and their potential predisposition to injury, and then alter his training programs depending on the findings that he has. He's really doing some interesting stuff -- some probably publishable, publication-worthy stuff that he is doing that he hasn't really shared with the masses, but kind of keeps to himself. I get to see it because I'm inside, but it's very, very interesting, very different, and I think has some real merit because of his ability to think a little bit different than most folks.

Talk about the Surprise facilities and Arlington facilities and how you go about deciding where the guys are going to do their rehab.

I think what the club has tried to do, and done very well, was duplicate the same facilities that we have here up in Surprise. The short-term injuries obviously will stay around here, but anybody involved in any long-term rehab, more than a week to 10 days, generally will go up to Surprise now and work with our training staff up there who are very well versed and very focused in treating the things that we see on the baseball field. I think that there are probably less distractions in that environment -- they can keep their head away from the stadium. Sometimes, it's a difficult thing for guys that are injured to deal with having to come to the stadium every day, but not being able to contribute and participate with their teammates. This takes them away and gives them the ability to focus on their injury and takes them away from the distractions, perhaps, that are normally around the ballpark. I think, in general, guys appreciate that. Then, when they are ready, they hit their rehab assignments, and they come back to join us.