The Mavericks’ Key to Keeping Players Fresh? Blood Samples

DALLAS — Whether they are trying to keep their 34-year-old playmaker Jose Juan Barea spry or aiming to help their 19-year-old phenom Luka Doncic dodge the infamous rookie wall, the Dallas Mavericks turn to the same resource: A blood test.

It is not just any blood test. The Mavericks import frequent testing from the Irish company Orreco, which is in its third season making personalized recommendations for Mavericks players regarding athletic workloads and diets, largely through the study of blood analysis.

Although some in the sports medicine community have questioned whether the value of such blood work is overstated, Dallas leans heavily on Orreco’s team of consultants and their assessments of how to maximize player-readiness.

“All the things N.B.A. teams talk about — players’ minutes, their load, their tracking data, their camera data — all of that is external data used to try to predict what’s going on internally,” said Casey Smith, the head of Dallas’s athletic training staff. “What we’re doing is trying to get a little bit of a look at what’s actually going on internally.”

Dallas is one of just two N.B.A. teams, along with the Knicks, to hire Orreco, which proposes customized remedies to combat fatigue and tries to identify increased risk for injury and illness by obtaining a range of data from players’ blood and feeding it into machine-learning programs.

Taking cues from Orreco’s findings, Smith and Jeremy Holsopple, the Mavericks’ athletic performance director, tailor an mix of training, rest and recovery for each of Dallas’s 17 players. The Mavericks' owner, Mark Cuban, said the team pays Orreco nearly $150,000 per year.

No Maverick has embraced this process more than Barea, who understands all too well that fatigued players face an increased risk of soft-tissue injuries.

Two seasons ago, amid worrisome forecasts from what Smith referred to as “the numbers” Orreco provides, Barea tore a calf muscle in a November 2016 game against Boston.

Ever since, Barea has proactively sought updates on his levels of oxidative stress (worrisome as they get higher) and white blood cell counts (which can indicate illness or infection when they spike or indicate less immune prevention as they get lower).

This season, Barea is playing some of his best basketball (averaging 10.9 points and 5.7 assists in just 19.8 minutes per game) and said he is “having more fun than ever” while carefully adhering to the suggestions Smith gives based off Orreco’s data.

“I like it,” Barea said. “At this point in my career, you have to work more on the body. They let me know what’s going on — like what you need to eat or what you need to stop eating. I want the feedback.”

Four times a season, Orreco staff members come to Dallas to administer a full venous blood draw on Mavericks players. To supplement those visits, Dallas mixes in frequent capillary blood draws for its players in which a quick pinprick sample is taken to provide near-instant readings of oxidative stress levels in the blood from a player’s ear or index finger.

League rules allow players to opt out of any blood testing if they find the procedures too invasive, but the team says only one Maverick, whom they declined to identify, had done so.

“It’s your health, so it’s your decision,” Smith said.

The samples, according to the Orreco co-founder Dr. Brian Moore, enable the firm to analyze a player’s hematology and biochemistry by assessing nearly 50 biomarkers.

This includes examining creatine kinase to assess muscle damage and high-sensitivity C-reactive protein to measure inflammation — two areas of particular concern for basketball players because of the nature of their on-court movements. Hydration and nutrition indicators — such as vitamin D levels, and iron and fatty acid profiles — are among the additional variables analyzed to determine where each player lands on a four-zone “readiness to perform” index.

Along with the biomarker panels, Orreco’s algorithms also take into account game minutes, air miles traveled, sleep data and reaction times that are obtained from wearable devices used during practices.

The rules that allow players to opt out of blood testing are in place because regulating how teams use biometrics and the data such research produces — specifically whether the data belongs to the teams, players or the league itself — remains an evolving point of concern throughout the N.B.A. As a safeguard amid the rise of wearable technology in practice sessions, league policy threatens fines of up to $250,000 per team for the misuse of biometric data.

Yet Smith insists that the collaboration with Orreco has improved the Mavericks’ ability to track the onset of illness and keep players “more available” for games. In the 2016-17 season, according to data maintained by, a website that tracks injuries in the N.B.A., Dallas players missed only four games due to illness — less than half the league average of 8.5.

The Mavericks then lost a league-low zero games to illness last season, when the league average was 7.1 games per team, according to the site.

“Does that mean we win more games?” Smith said. “Not necessarily. But it gives us a better shot.”

Still, with the sports and fitness world littered with treatments not supported by vetted published studies, some independent experts have their doubts.

Dr. Anthony Romeo, the chief of orthopedics at the Rothman Institute in New York and a former team physician for the Chicago White Sox who also worked with the Chicago Bulls, said he would maintain “a healthy level of skepticism” about Orreco’s work until it reveals more about the biomarkers it studies and the data being gathered.

”I would be cautious and say it’s investigational,” Romeo said. “It’s a very interesting area of research and we applaud the efforts that they’re making. But at this time nothing supplants outstanding coaches and trainers that can do a visual analysis and understand their athletes from the traditional methods to know whether they’re training too hard or too little.”

“At some point,” Romeo said of Orreco, “they’re going to have to share their data in a way that it can be repeated so that we know it’s true.”

Said Dr. Robert Dimeff, a team physician for the Dallas Stars of the N.H.L. and a past president of the American Medical Society for Sports Medicine: “I think this is a research-based tool at this point in time, but I don’t think it’s ready for prime time. What they’re doing is something that in 10 years from now we may say, ‘Wow, this is absolutely great information.’

“We can’t say that right now. But what they’re doing is trying to put some science behind recommendations and I think that’s very admirable.”

Despite such skepticism, Cuban remains one of the biggest proponents of Orreco’s work. After watching an interview in which the openly data-hungry Cuban discussed his growing fascination with artificial intelligence, Moore wrote to Cuban before the 2016-17 season with a pitch that Orreco could “optimize performance, accelerate recovery and prolong careers” by using “high-end computing to find patterns in the data.”

“Our job is to help the Mavericks make better decisions,” Moore said.

Cuban was quickly sold.

“Managing player load is as important as understanding traditional basketball analytics,’’ Cuban said. “Causation is always more valuable that correlation.”

Although the Mavericks are hardly alone in embracing bioanalytics, they are on a very short list of top-level professional sports franchises and are willing to ignore the ultra-secretive norm and publicly acknowledge its work with Orreco.

Aside from the Mavericks, only Newcastle United of the English Premier League has acknowledged being an Orreco customer. Through a person with knowledge of the contract, The Times confirmed that the Knicks are the other N.B.A. team to use Orreco as extensively as the Mavericks.

Orreco also consults with a handful of individual players, including Wilson Chandler of the Philadelphia 76ers and Quincy Pondexter of the San Antonio Spurs.

The company declined to discuss the Knicks, or the two Major League Baseball clubs and another Premier League soccer team it counts as clients.

Smith cited Quest Diagnostics’ Blueprint Fit as another top practitioner in the field that he suspects has an N.B.A. clientele and acknowledged that several of his peers within the league are aware of what Dallas is doing, and asking lots of questions.

“And I think there will be more,” Smith said.

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