The Sports Injury Management Playbook

Scott Waugh, PT is the clinical director of Mass General Brigham Sports Medicine Physical Therapy and Massachusetts General Hospital Sports Medicine Physical Therapy. He is also the rehabilitation coordinator for the Boston Bruins, and a consultant for the Boston Red Sox.

Throughout the course of his over 30-year career spent both in clinical settings and with professional athletes, Waugh has helped develop and hone playbooks for critical sports injuries that can be adjusted to fit the needs of professional and amateur athletes alike. Today, he brings that knowledge to his work at Mass General Brigham Sports Medicine. In this article, Waugh discusses injury playbooks, the impact of his work with pros on patients of all levels, and what it’s like to treat patients at Mass General Brigham Sports Medicine.

Treating the pros: The injury playbook

Imagine you’re a recently injured professional athlete, and you’ve just entered treatment. Your care team has worked with you through the diagnostic phase of your treatment—but now you need a plan to help you rehabilitate and get you back to your sport.

That’s where Waugh and his team come in. “When you’re able to return to play, say, a professional hockey game, you’ll probably have been skating for 3 or 4 weeks. So there are frequency, duration, and intensity skill level. I organize all of that. I’m the person that decides the return-to-play plan and, when athletes are ready, when it’s okay for them to go back.”

Waugh takes a strategic treatment approach to every injury. “I always use the word ‘playbook,’” Waugh says. “Every injury we see has a playbook, meaning we have a designed plan and program for every injury you can think of. There are steps along the way, there are algorithms to all this—and we’ve done this for so long that we’ve developed playbooks. We don’t just treat patients and hope they get better. We make them better.”

As Waugh explains, the injury playbook must be tailored to each athlete’s unique needs. “There are stages along the way: How to treat them acutely, how to treat them sub acutely, and how to interact with their strength and conditioning so that we're maintaining fitness. At the same time, we're managing injuries so that we're not waiting until 6 weeks pass. Okay: The injury's better, but now the athlete is deconditioned and out of shape. In other words, there are creative ways in which we blend the medical aspect with fitness, so these professional athletes can maintain an elite level while we're managing the injury. Then I impart the performance and return-to-play aspects of treatment.”

Adapting the playbook for amateur athletes

Working with the professional athletes like the Bruins and Red Sox has honed Waugh and team’s strategic treatment skillsets. “In dealing with the pros, we leave no stone unturned. We’ve figured out any treatment that can help these athletes; it’s enabled us to really be strategic with our clinical care. So, for example, I just worked with a high school football player and within 4 or 5 minutes we were able to outline a plan because we’ve done it with the Patriots. There’s not a lot of guesswork because we’ve learned so much over the years with the pros; we’ve been pushed to make sure we get players back quickly and safely.”

In other words, those pressure-honed strategies have limbered Waugh and his team. As a result, the injury playbook—with a few adaptations—has proven efficacy with athletes of all levels.

“The playbooks for amateur athletes and pros are very similar. It’s the intensities that are a bit different. With the regular population, we can be less aggressive,” Waugh explains. “Injuries get better in time, but in pro sports, you don’t necessarily have the luxury of time. So it's a much more active, aggressive plan to rehabilitate and get professional players back as quickly as possible, whereas with the everyday population, sometimes it can be more of a passive process. We’re able to plug the patients we see into accelerated programs and less accelerated programs depending on the injury and athlete.”

World-class sports medicine care at Mass General Brigham

Waugh and his team of experts at Mass General Brigham bring cutting-edge, professional care to each of their patients.

“At Mass General Brigham, we have a deep bench of experience,” Waugh says. “We know how to manage injuries better than anybody else because we’ve done it more than anybody. And we’ve got an organization that supports us. Having all these professionals come to us and rely on us speaks volumes to the commitment levels of our program and the high level of care we’re able to deliver.”