There鈥檚 a saying that playing in an NFL game is like being in a car crash.
Buffalo Bills fullback Reggie Gilliam would like to correct that perception.
鈥淚 would say it鈥檚 like being in multiple car crashes,鈥 Gilliam laughs, despite the fact he鈥檚 not joking.
鈥淚t鈥檚 like being in a car crash 40 times,鈥 says defensive tackle Dawuane Smoot. 鈥淵ou鈥檙e sprinting into each other.鈥
The underappreciated process of recovery is like a full-time job for NFL players 鈥 on top of the full-time job of studying, practicing and playing games. Players utilize a slew of high-tech and low-tech treatments to get their bodies ready to take the field in the six days 鈥 and sometimes fewer 鈥 between games.
We鈥檙e talking ice baths, in which they sit in a single-person tub of ice water that鈥檚 between 48 and 52 degrees. You think that鈥檚 cold? They also can stand in a cryogenic cold chamber for two minutes that鈥檚 minus-180 Celsius (minus-292 Fahrenheit). They use hot tubs. Hyperbaric chambers. Massage. Chiropractic. Ultra-violet light therapy. Intravenous infusions. Acupuncture. Platelet-rich plasma injections. Stem-cell therapy. Cupping therapy. Electrical stimulation. And on and on.
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鈥淚t鈥檚 2024,鈥 says Bills defensive end Von Miller. 鈥淵ou want to take advantage of all the sports science. Preparation for the game is one thing; recovery is another that鈥檚 just as important.鈥
What does Miller prefer?
鈥淚 do everything,鈥 he said. 鈥淚 don鈥檛 go home and just chill. Every single day I have a two-hour session at least. Tuesday, I have a stretch, Wednesday, I have a massage, Thursday, I鈥檝e got dry-needling. Friday, I get an IV. Saturday, I get stretched again. ... I cold-plunge Monday, Wednesday, Thursday and Friday. I go to the sauna those days as well. Whatever they鈥檝e got, I鈥檒l do it. Before the game, I get worked on again.鈥
The Bills offer most of these therapies on site at the team facility. But almost every veteran NFL player has his own personal therapist 鈥 or therapy team 鈥 that supplements their recovery at home.
鈥淚 would say I spend $50,000 to $100,000 for the year,鈥 says Smoot, an eighth-year veteran, who鈥檚 currently on injured reserve because of wrist surgery. 鈥淭hat鈥檚 flying people out, making sure I have the machines and everything I can do. I bring my PT up here each and every weekend from Jacksonville. I鈥檝e been working with her three or four years now.鈥
That kind of expenditure is the norm.
鈥淕uys are making millions of dollars a year,鈥 says Buffalo Rehab Group CEO and president Jeff Woodrich, who has worked with more than 50 former and current NFL players, on the Bills and other teams. 鈥淭o spend $50K or $100K on a body guy or a performance guy 鈥 almost every guy on their second contact has one, and it鈥檚 a wise investment.鈥
The recovery process starts as soon as the game ends.
鈥淎s they come through with injury checks in the locker room Sunday night after the game, we鈥檙e getting on top of it, so we know what we鈥檙e dealing with Monday morning,鈥 says Nate Breske, the Bills鈥 head trainer. 鈥淭hen guys naturally come in more sore Monday, and we鈥檙e working on how can we get this to calm down, how can we get them feeling better so they鈥檙e ready to practice by Wednesday. Mondays and Tuesdays, these guys are not only mentally recharging but physically beat up after the game.鈥
Bills head athletic trainer Nate Breske stretches and loosens quarterback Josh Allen鈥檚 throwing arm before a practice in Orchard Park.
Ice-tub therapy
NFL players have been plunging into cold tubs for many decades. Bills Wall of Famer Booker Edgerson says he was doing it in the 1960s.
鈥淲hen you talk about the sports science of recovery,鈥 Woodrich says, 鈥渋t ultimately comes down to increasing blood flow and decreasing inflammation. Those are the main things you do.鈥
Sitting in a cold tub decreases inflammation.
鈥淚 do it two or three days a week, and if I鈥檓 doing the cold tub only, I鈥檒l sit in for 10 minutes,鈥 cornerback Taron Johnson says. 鈥淚f I鈥檓 doing the cold tub and the hot tub, I鈥檒l do 5 minutes in one, 5 minutes in the other for 20 or 25 minutes.鈥
How does the cold tub feel?
鈥淚t sucks,鈥 Gilliam says. 鈥淭he first minute, minute and a half, it鈥檚 terrible. Then you go numb and it feels good.鈥
Most players told The 69传媒 they like to alternate the cold and hot tubs, which they call 鈥渃ontrast,鈥 rather than do the cold tub only. And many put Epsom salt in the hot tub.
鈥淚 prefer it,鈥 Breske said of using contrast. 鈥淓verybody鈥檚 got their own routine. When we鈥檙e coming off an injury, we like contrast because you can get the blood in there with the hot. It helps the blood flow. And the cold decreases inflammation. So it鈥檚 like wringing out a sponge, almost, where you get in, open the vessels, then close the vessels. That鈥檚 where the contrast comes in.鈥
鈥淚鈥檓 big on the ice bath,鈥 safety Damar Hamlin says. 鈥淚 had some injuries in college where the ice bath was the only thing that helped me. I do it probably four days a week, 10 minutes.鈥
They also can stand in the Bills鈥 cryogenic cold chamber, which is a lot like the cold tub, only faster.
鈥淎t least twice a week I鈥檒l do cryo,鈥 center Connor McGovern says. 鈥淲e have a cryotherapy room. It鈥檚 a room that gets down to minus-180 (Celsius). You鈥檙e in there 2-3 minutes. You wear special slippers and gloves and a hat so you don鈥檛 get frostbite. I feel like it helps calm the body down.鈥
Bills head strength and conditioning coach Eric Ciano works with injured defensive tackle DeWayne Carter on conditioning during a practice earlier this month.
Day-after weight training
It may be counterintuitive to think the players would want to lift weights the day after the game, but they say it鈥檚 a critical part of their recovery.
鈥淵ou鈥檝e got to get a lift in immediately,鈥 Smoot says. 鈥淵ou鈥檝e got to get all the lactic acid pumped out of you. That鈥檚 what we usually do Monday. We go straight to lifting, and then I鈥檓 able to do the hot and cold therapy.鈥
鈥淔or me, I go as hard as I can go in the weight room Monday,鈥 Johnson said. 鈥淚f my body doesn鈥檛 feel good, I鈥檒l take it easy. But if it feels good after the game, I鈥檒l go heavy. It鈥檚 important to get that lactic acid out.鈥
The high-intensity workout of playing in an NFL game causes lactic acid to build up. Lifting weights increases blood flow, which flushes excess acid.
Tackle Spencer Brown said the importance of getting in the weight room Monday was a big lesson he learned as a pro.
鈥淚n college, I didn鈥檛 want to do anything the day after the game,鈥 Brown says. 鈥淚 was like, 鈥業 just want the body to recover. Do nothing.鈥 That鈥檚 what I tried to do my rookie year, and I鈥檇 get behind the 8-ball. You may not want to do it, but getting rid of the lactic acid is huge.鈥
Like many veterans, Brown has embraced a routine that works for him.
鈥淚 lift four days a week or my body will start deteriorating, and I鈥檒l just get light,鈥 says the 6-foot-8, 311-pounder. 鈥淭hat鈥檚 what I also learned my first two years. So I lift four days a week 鈥 Monday, Tuesday, Thursday, Friday. Saturday鈥檚 a big recovery day for me.鈥
Mondays are sometimes the most difficult, because extra effort after a game pays long-term dividends 鈥 even though the brain is telling the body it wants rest.
鈥淭hat鈥檚 what you want to do 鈥 sit around,鈥 Gilliam said of Mondays. 鈥淚t feels good to not move. It sucks to lift the day after the game, but you need that to be able to feel good the next day.鈥
What can the average recreational athlete learn from this?
鈥淕et out there and move around,鈥 said Breske, hired by Sean McDermott in 2018. 鈥淵ou move it or you lose it. You鈥檙e better off getting out and doing something. You don鈥檛 want to overtrain, but you want to make sure you鈥檙e moving around the next day. ... And weight training is probably more important than the cardiovascular training in a lot of regards, especially as you get older. It helps your body. It burns calories.鈥
Soft-tissue therapy
Some football injuries fall into the category of unavoidable wrecks. Receiver Keon Coleman has missed the past two games with a wrist injury, suffered when the helmet of Miami safety Jordan Poyer smashed into the wrist late in their game Nov. 3. No amount of pregame therapy protects a player when a helmet crashes into an exposed body part. But all the massaging is geared toward preventing injuries like calf, quad and hamstring strains.
鈥淚 do massage once a week, every Tuesday,鈥 McGovern says. 鈥淎nd I have my own personal PT also. I do my own physical therapy at my house. I see them six days a week. I brought him with me from Texas.鈥
Brown also believes in getting loose, and trying to stay loose.
鈥淭he day after the game, I go to meetings and maybe get a massage,鈥 Brown said. 鈥淭he second-day massage. Then I usually do the underwater treadmill to get the body moving.鈥
Gilliam said he sees a masseuse and a chiropractor Monday, then gets another massage Saturday.
鈥淭hen I have all the Hyperice Normatec massage guns at home,鈥 Gilliam said. 鈥淚 have a foot massager. I have a huge massage chair in my basement.鈥
Jake Woodrich is a physical therapist who works for his father and who also has worked with the Boston Red Sox training staff. He explains the need for increased blood flow and several ways to achieve it:
鈥淭here鈥檚 something called instrument-assisted soft-tissue therapy,鈥 Jake Woodrich says. 鈥淚t鈥檚 basically where you use an instrument to work different areas of the body on different muscles. Again, the idea behind it is increasing blood flow. If you鈥檙e massaging a muscle or some different soft tissue, it brings more blood flow to that area to help things heal a little bit quicker.鈥
Another form of this is suction-cupping. Walk around the Bills locker room on a Wednesday or Thursday and it鈥檚 common to see some players with perfectly round bruises, 2 inches in diameter, on various body parts.
鈥淪ay you have a sore quad,鈥 Gilliam explains. 鈥淏y using a cup, it brings blood to that area and makes your brain say, 鈥極h, there鈥檚 an injury here, let鈥檚 put blood cells there to help repair it. It鈥檚 like purposely bruising yourself to tell your brain it needs more attention.鈥
Other therapies
Oxygen chamber. 鈥淚 like to do a hyperbaric chamber,鈥 Smoot says. 鈥淪o I鈥檒l sit in there for about an hour an hour and a half. I do that every day. I鈥檝e got one at home. It鈥檚 oxygen therapy 鈥 pure oxygen so it just speeds up your recovery that much more.鈥
Acupuncture. 鈥淚 do needling 鈥 acupuncture,鈥 Johnson says. 鈥淎fter a game, if I feel tight, then I鈥檒l do it after a game for recovery. If I feel pretty good I鈥檒l go the whole week without doing it, then I鈥檒l do it again on Friday.鈥
鈥淚 do needling,鈥 linebacker Nicholas Morrow says. 鈥淚f I鈥檓 really tight, that helps. The best way to put it is, if you feel a knot, the needle will loosen it up. But everyone doesn鈥檛 respond the same way. Some people get sore from it, but I don鈥檛 get sore.鈥
Infrared therapy bed. 鈥淚 do the red-light bed,鈥 Hamlin says. 鈥淚 don鈥檛 know what it does; you鈥檇 have to ask the trainers. But I like it.鈥
(The heated bed increases blood flow.)
IV therapy. 鈥淕uys are going for IVs, and usually a nurse practitioner is doing it,鈥 Jeff Woodrich says. 鈥淭hey鈥檒l come to their home 鈥 and they get IVs. It鈥檚 injecting (and) rejuvenating with minerals 鈥 or supercharging their vitamins. It could be vitamin B. There鈥檚 all different type of cocktails. They鈥檙e usually doing it on a Tuesday and a Friday. It鈥檚 a little different than getting an IV when you鈥檙e dehydrated. It鈥檚 the vitamins that you and I take, and they鈥檙e putting it in an IV bag.鈥
PRP therapy. It鈥檚 common for players to try to speed up recovery from an injury by getting a sample of their own blood drawn, then having it placed in a centrifuge, which rapidly spins the sample. The platelets in the blood are separated, then reinjected into the injury area.
Full-service facility
The Bills do PRP therapy for players who need it right at the facility. They have the cryogenic chamber and a hyperbaric chamber on site.
Breske heads a five-person full-time training staff. The Bills have five full-time strength and conditioning coaches and four performance science employees.
The Bills also bring in contractors every week for massage, chiropractic and acupuncture therapies.
鈥淚 can鈥檛 say enough about the Pegulas and what they鈥檝e done to make the facilities state-of-the-art,鈥 Breske said. 鈥淭hey鈥檝e put their money where their mouth is, trying to help these guys recover and take care of them. They鈥檝e never blinked an eye at anything we need. Coach McDermott and Brandon Beane feel the same way.鈥
Jeff Woodrich adds: 鈥淲hat I hear from players is that the Bills鈥 strength and conditioning and their recovery program, and the facilities they have for the players, is top-five in the league. The team deserves a shoutout for what they have there.鈥
Is six days enough time to recover? Usually.
鈥淏y Thursday, I鈥檓 usually back to normal,鈥 Gilliam says.
鈥淪peaking for myself, we practice hard on Wednesdays and Thursdays,鈥 Johnson says. 鈥淏ut we鈥檙e in pads on Wednesdays, so we鈥檙e hitting each other a little bit. So I鈥檓 pretty sore after that practice. I would definitely say it鈥檚 challenging, and I鈥檓 probably ready by Saturday, the day before the game.鈥
Smoot says for his money, he usually doesn鈥檛 start to feel really good until Friday and Saturday.
鈥淎nd then,鈥 Smoot says, 鈥測ou go out Sunday and you mess it all up again.鈥
