Alex McKechnie’s New Role with Toronto Raptors Extends Journey as Leader in Sports Science

Alex McKechnie wants to set the record straight. The Toronto Raptors’ newly promoted vice president of player health and performance didn’t invent the term “load management”; it’s been used over the years to describe everything from how electricity moves to how hospitals schedule shifts for nurses. But the success Alex had in stewarding Kawhi Leonard and company through the 2018-19 season, en route to the franchise’s first NBA championship, has elevated those two words into the league’s popular lexicon.

The thing is, as Alex sees it, that rise in popularity has led to a broad misunderstanding of what load management actually means.

“People seem to think, ‘Okay, load management, you're playing 60 games and that's it,’” he tells CloseUp360 by phone from his office in Toronto. “It's not about necessarily resting. It's about managing the load, meaning exactly what it means.”

As Alex goes on to explain, managing a load refers to sustaining a consistent workload.

“The one thing you want to try to avoid is a yo-yo effect,” he continues. “You're working hard and all of a sudden, you're doing nothing for a period of time, and then you’re working hard again. The tissues just don't react well to that kind of load management. 

“So it's about establishing a proper care pattern for each player, and understanding when to rest and when to continue working. And there's a science to that and there's an art to it. And you have to blend them both.”

If Alex and his staff in Toronto aren’t the best in the business at navigating that art-science balance, they’re certainly among the elite. Their recent results speak for themselves.

That’s just as true of Alex’s own 45-year career in sports medicine. He’s spent much of that time as one of the most sought-after physiotherapists in the world, thanks to his sterling record of success in treating a long line of NBA stars that includes Shaquille O’Neal, Kobe Bryant, Steve Nash, Tracy McGrady and Baron Davis, as well as luminaries in other sports. Along the way, Alex has helped to draw a clearer line from sports science and player health to winning and losing—with load management’s emergence as a buzz term serving as just the latest link in his ongoing chain.

Alex McKechnie

Alex McKechnie won five NBA championships with the Los Angeles Lakers before helping the Toronto Raptors claim their first title. (Courtesy of Alex McKechnie)

Like the rest of the Raptors, Alex got to spend some personal time with the Larry O’Brien Trophy this past summer. For two days, he squired that coveted golden basketball hoop around Vancouver. He presented it at the British Columbia Sports Hall of Fame, into which he was inducted in 2018. From there, he took it to Burnaby—the Vancouver suburb where he’d built the foundation of his career in sports medicine—to show it around city hall and the local fire department, where he had looked after firefighters for years.

Then, Alex brought the trophy to a group of underprivileged kids, from whom he fielded all kinds of questions. The best one?

“Really, it's always the same question,” he says. “‘How do you get to where you are?’”

For Alex, the answer begins where he began: on the east end of Glasgow, in a post-World War II housing project called Easterhouse.

“It was kind of a gangland area that I grew up in, but that's the way it was,” he says.

Surrounded by struggle, Alex and his three siblings followed their parents’ example of hard work. Their father, also named Alex, labored in the local shipyards before moving on to Albion Motor Works in Scotstoun. Their mother, Betty, worked as a cleaner at the elementary school where Alex was educated.

A young Alex dreamt of a future not in basketball—which hardly registered in the United Kingdom in the 1950s and 1960s—but rather in professional soccer, as did so many of his peers in Easterhouse. He would also be exposed to what became his passion through family misfortune. 

When Alex was a teenager, his father and older brother, Matthew, were injured in a car accident. The elder Alex tore up his knee, while Matthew broke his femur.

“I remember going with him as a young lad to the rehab things they were doing. That's when I kind of got interested in it,” Alex says. “Then, when I realized I wasn't good enough to play professional soccer, I thought, I've got to somehow stay involved here, and that's when I really took a keen interest in the whole sports medicine thing.”

With that goal in mind, Alex excelled in school and matriculated to the Leeds School of Physiotherapy in Yorkshire, England. After graduating in 1974, he decided to take his skills and credentials elsewhere within the British Commonwealth. He applied to emigrate to either Australia or Canada and, at the age of 22, got his first job out of school as the head physiotherapist at Simon Fraser University in Vancouver.

Alex McKechnie

Alex began his career in physiotherapy at Simon Fraser University in 1974. (Courtesy of Alex McKechnie)

Alex worked with all of the varsity sports teams at the school. And though football had the biggest budget, “I took a liking to the basketball guys,” he says.

Not that the basketball players saw anything approaching affection in the way Alex needled them through exercises like a drill sergeant.

“We hated seeing him,” Jay Triano, who trained with Alex on Simon Fraser’s basketball team, tells CloseUp360, “but he was our physiotherapist and put us through all this training. I know his background was soccer, and being from Europe, we were, like, ‘It's gotta help us,’ so we kept doing it.”

Alex’s exposure to various sports and the injuries that afflicted their respective athletes led him to cross-pollinate with his training methods. Instead of telling the basketball players to do defensive slides and shuffle their feet, he’d push them to do perfect burpees and work on switching, from standing to sitting (and vice versa) on a dime. Rather than having them run suicides on hardwood, he’d instruct them to do commando crawls up and down the length of the university’s football field—or up a steep grass bank from the field to the gym.

“And he'd be, like, ‘Are you tired?’” Jay recalls. “If you said yes, then he'd say, ‘Well then, you're not in very good shape.’ So the next time, we'd do it again. He'd go, ‘Are you tired?’ and we'd go, ‘No.’ Then he goes, ‘Well then, you're not working hard enough.’

“He just had an answer for everything.”

“I drove them pretty hard, I must admit,” Alex confesses. “But you know what? You better be the fittest team on the block.”

That much remained true for Alex, even after he left Simon Fraser to open his own clinic in Burnaby in the late 1970s. When he wasn’t busy helping local firefighters and police officers return to work after getting hurt, he was usually consulting with professional athletes of all stripes. He trained the Vancouver Whitecaps, then in the North American Soccer League, and the Vancouver 86ers of the Canadian Soccer League. He also consulted with the Vancouver Canucks and the NHL Players’ Association, and worked closely with the likes of soccer star Owen Hargreaves, tennis legend Jimmy Connors, Olympic figure skating champion Michelle Kwan and NFL standout Terrell Owens.

“It was the infancy of sports medicine, really, back then in terms of the city,” he says.

As he proceeded, Alex took a particular interest in ACL injuries. He kept seeing how those devastating knee problems were tied to a lack of control in the pelvis—which, in turn, connected to the core. He also noticed how sports hernias related to the same region of the body, and thought even more seriously about the importance of core strength to maintaining overall health among athletes. But even in the mid-1990s, the tools for addressing those deficiencies were rudimentary at best.

Then one day, Alex had an epiphany. While walking his dog, he passed by a playground, where he saw a kid bouncing on a spring. That inspired him to combine a spring with a piece of plywood for what would become the Core Board, a strengthening tool that he eventually licensed to Reebok.

Alex continued to observe and experiment with different methods and modalities during his time as the head trainer of the Canadian men’s national soccer team. He had the players using elastic resistance bands to pull off core movement patterns that he was still developing at the time.

And while Alex won’t take credit for the players’ on-field success, he was an important part of a team that, in 2000, stunned Colombia, a South American soccer powerhouse, to win the CONCACAF Gold Cup—and, in the process, get Alex as close to his dream of competing professionally on the pitch as he ever would get.

“This was a Canadian team that wasn't expected to do anything,” he says. “It was one of those incredible experiences.”

Alex doesn’t see himself as a leader in his field, and never intended to become one. And really, his opportunity to work in the NBA at all, much less be a part of six championship teams, almost slipped right through his fingers.

It was December 1997. Alex was inside his office at his clinic in Burnaby when a life-changing call came through. The Los Angeles Lakers were on the line, and they needed Alex’s help.

Shaquille O’Neal, the Lakers’ prized free agent addition from the summer of 1996, had just re-aggravated a pesky abdominal injury that had surfaced during the preseason in October 1997. One more wrong move, and Shaq’s entire career could’ve been derailed.

As it happens, Paul Kariya, then a star for the NHL’s Anaheim Ducks, had recently suffered a similar injury. Gary Vitti, the Lakers’ athletic trainer at the time, had asked Dr. Stephen Lombardo at the famed Cedars-Sinai Kerlan-Jobe Institute to figure out who was behind Paul’s remarkable recovery.

Turns out, it was Alex. With his expertise, along with the Core Board and Core X System—the latter of which was built off the work he did with the Canadian men's national soccer team—Paul had not only rebuilt his ailing abdominal muscles, but also regained the All-Star form that eventually landed him in the Hockey Hall of Fame in 2017.

The Lakers, then, asked Alex to do for Shaq what he’d done for Paul.

Even with all the experience and expertise Alex had accumulated across more than two decades as a working physiotherapist, Shaq would be, both literally and figuratively, his biggest client—not just in basketball, but in any sport.

With the Diesel on the docket, Alex closed his office for the following Monday afternoon. The plan was Shaq would spend that morning with Dr. Ross Davidson, a renowned orthopedic surgeon in Vancouver, and then visit with Alex at 1:30.

“So I get a call at 10:30 in the morning that they're coming over,” Alex recalls. “I said, ‘Well, I'm not ready to see you.’”

At that point, Alex didn’t have room in his schedule to improvise. He had just returned from a road trip with the Canadian men’s national soccer team, and had an office full of patients waiting to see him that morning.

“I certainly couldn't cancel on the people who were there,” he says.

Rather than crash Alex’s office, Shaq and his contingent drove to the airport and flew back to LA. His most prominent potential client yet had left town without paying him a visit.

“It may never have happened, quite frankly,” Alex says. “It could've gotten to that point where it never happened.”

The next day, another call came in. It was Dr. Lombardo again. He wanted to apologize for what had happened, and to ask if Alex would be able to see Shaq when the Lakers came to Vancouver to play the Grizzlies during the first week of the New Year.

“So I said, ‘Of course, I'll do the same thing again,’” Alex continues. “I locked my office up again, four o'clock, waiting to see him to come. And then, of course, low and behold, he shows up on that particular day, a Tuesday afternoon, and the rest is history.”

As with Paul, Alex helped Shaq return to competitive domination by rebuilding his abdominal muscles using the Core X System. Shaq, in turn, became a seasonal mainstay at Alex’s office. For the next two years, he spent his summer in Vancouver, working with Alex in the afternoons after manning the front desk in the mornings.

“He'd bring our reception staff lunch every day, bring them in burgers, whatever,” Alex recalls. “He was just the best. He would introduce himself to all the patients coming in, patients that were there to see other therapists. It was just an amazing experience.”

The results were even more amazing for Shaq and the Lakers. In 1999-2000, he was named NBA MVP while leading LA to a league-best 65 regular-season wins and the first of three straight championships. Alex was there for every step—not solely as Shaq’s physical confidant, but as a full-time member of head trainer Gary Vitti’s staff. By 2003, Alex had become the team’s athletic performance coordinator, and hung on long enough to win five rings, including two with the Kobe-led, post-Shaq Lakers.

In the summer of 2011, the NBA and the National Basketball Players Association found themselves standoff over the future of the league. The resulting lockout would put the 2011-12 season in limbo, along with the jobs of team employees from coast to coast.

The Lakers were no exception. The team either laid off or didn’t renew the contracts of a swath of coaches, scouts, front office executives and medical staff, including Alex.

But by the time those problems truly hit the fan, Alex was already long gone. He’d returned  to his private practice in Burnaby shortly after the Lakers were dispatched from the 2011 playoffs by the Dallas Mavericks.

Not long after he settled himself in Burnaby, Alex got a call from Jay Triano. Jay had gone on from Simon Fraser to play for the Canadian men’s national basketball team before getting into coaching at both programs. After spending six seasons as an assistant coach with the Raptors, he got the top job in Toronto in 2008. Following the 2010-11 season, Toronto declined to pick up Jay’s option as head coach, choosing instead to move him into the front office as the team’s vice president of pro scouting.

When Bryan Colangelo, then the Raptors’ general manager, sought to overhaul the organization’s medical and training operation, Jay knew who to bring in.

“You wanna upgrade the medical staff? Let's go after the best,” Jay told Bryan. “Let's go see if we can get McKechnie out of L.A.”

“There's no way we can do that,” Bryan replied.

Jay, though, thought otherwise. He had remained friends with Alex in the decades since they were both at Simon Fraser. He’d taken the time to catch up with Alex whenever their paths crossed (typically before games between the Raptors and Lakers), and knew that Alex was in limbo.

“Well, give him a call and feel it out,” Bryan told him.

So Jay reached out, only to find that Alex wasn’t exactly jumping through the phone about the idea.

“I didn't say yes, I didn't say no,” Alex recalls. “I just said, ‘I'll think about it.’”

“I went back to Bryan and I said, ‘I think there's a chance,’” Jay recalls. “And he said, ‘Well, bring him out here and let me talk to him, if he's that interested.’”

A couple days later, Jay called again.

“Listen: I've gotten the green light here to bring you in,” Jay told Alex. “I'll get the tickets for you and your wife to come through to Toronto and let's meet with Bryan.”

“I remember going back to Bryan's office and saying, ‘Hey, they're coming on a weekend,’” Jay says. “He goes, ‘This weekend?’ And I said, ‘Yeah, you wanted me to do it, I got it done.’

“He was like, ‘Holy smokes! Okay, this is great.’”

So the McKechnies flew to Toronto, “and Bryan hired me right there,” Alex says, to be the team’s director of sports science—making him one of the first people to hold such a position in the NBA.

The greater trepidation came from Alex. He wanted free reign to not only run his department how he saw fit, but also to build it from the ground up with preventative care as a focus, “as opposed to just being the trainer and being totally reactive,” he says.

The Raptors met his demands, and left him to his devices even after the team replaced Bryan with Masai Ujiri in 2013.

Step by step, Alex reshaped Toronto’s sports science operation around a preventative care model. Rather than hiring a fleet of new employees, he worked to integrate what he found to be a fragmented department.

“There was a weight room over here and a strength coach in the weight room working on his own,” Alex says, “and a trainer basically working on his own and the trainer piecemealing some of the stuff out to different people.

“I said, ‘We can't do this.’”

Working with much of the staff the Raptors already had in place, Alex restructured his department to improve communication and cooperation between its various aspects. All the while, he was guided by the same philosophies that had helped him throughout his career. One was B.U.I.L.D., an acronym for Basic principles, Utilizing skill sets, Identity, Longevity and Diversification. Another was “treat locally, rehab globally,” referring to the need to keep the overall body in shape while dealing with injuries in specific areas.

“You take someone with a wrist injury, for example,” Alex explains. “Obviously, they can't go in there and shoot, right? But you've got to maintain their general conditioning. You've got to maintain everything with ability.

“The first thing they're going to do when they get back on the floor is get up 1,000 shots. Well, their legs are gonna start to go if you don't maintain and sustain the workload on their legs and on their shoulders—things that are going to be active during that period. Then you go on break. Now, you're gonna start to fall into this double spiral of injury, so you've got to sustain and maintain the load.”

Which brings him back to another familiar phrase: load management.

“During that period when the player's off, we have to figure out a way to sustain the load, so he can maintain a fitness level,” he continues. “That's how you rehab globally. You're just treating it locally, for sure. You want to get range of motion back, get strength back and all the different things you may do to treat things from a local perspective. But you've got to make sure that when the whistle blows, he's ready to go.”

With Alex at the helm, no team in the NBA has done that better than the Raptors. According to In Street Clothes—a website founded by Jeff Stotts, a certified athletic trainer, who tracks injuries in the league using analytics—Toronto registered the fewest games lost to injury between 2013 and 2018. Last season, Alex and his staff helped Danny Green recover from nagging groin issues and, more famously, helped Kawhi navigate around a quadriceps injury that all but ended his tenure with the San Antonio Spurs.

That set up the Raptors for their most successful season in franchise history, though, again, Alex won’t take credit for it.

“I think it's easy to say you contribute here and there, but the fact of the matter is, it’s players that win games, right? And there's coaches in there,” he says. “But in the same token, it's my role to put our players in the best environment to succeed. That's where the role exists, and that's our role as a group.”

As exhilarating as the 2019 NBA Finals were for the Raptors, as a validation of all they had built to become champions, the series wasn’t without some gut punches for Alex. He felt for Kevin Durant, who went down with an Achilles tear in Game 5, and for Klay Thompson, who tore his ACL in the decisive Game 6.

He also couldn’t help but sympathize with Dr. Rick Celebrini, the Warriors’ director of sports medicine and performance. Rick was faced with an unprecedented string of career-altering injuries on the game’s biggest stage, along with public scrutiny in their respective aftermaths.

“We've all been there when players go down. It's no question,” Alex says. “Of course, you feel for him. Rick's a close friend.”

Rick had risen toward the pinnacle of the profession after working under Alex for years at Fortius Sport and Health in Burnaby. When Alex left the Lakers for the Raptors in 2011, he did so to serve in a full-time, year-round role. That meant putting Fortius in the hands of his successors, including Rick, a Burnaby native who had played soccer for the 86ers in the 1990s and worked as a physiotherapist for the Whitecaps during their revival in Major League Soccer.

Eight years later, they stood opposite one another, teacher and pupil seeing eye to eye as competitors. But Alex’s influence on the field of sports medicine extends far beyond his direct disciples.

Alex Explains B.U.I.L.D.

"You BUILD a career. Basic principles never change, no matter what it is. The fundamentals of accounting are the same, they're going to be the same. Right column has got to equal left column. Building a house, you put a foundation in. You use basic principles. In my world, joints move so you have to move them. Muscles move joints, so you'd better work them.

"There's U, how you utilize your skill set of people around you to make you better, everybody else better around you. I think that's really important.

"Next comes I, which is identity. Your identity, with that, you have to have integrity, and you can't sacrifice your integrity at all.

"It's your identity that ultimately gives you the longevity and the ability to last, and continue on the journey over the course of your career.

"And it's longevity that allows you to do what I'm doing now, which is a diversification in my role. So it's BUILD, a belief that's what I live by."

For one, his performance department with the Raptors has become a shining example for (if not the envy of) the rest of the NBA. Alex and his staff are seamlessly integrated into the broader organization as one of its three “pillars,” the other two being the front office and coaching staff.

“They can't be single entities,” he insists. “They have to be completely related.”

He’s taken his Core Board and Core X System from fledgling commercial products to critical components of injury recovery and prevention. While the NBA at large is grappling with how to tackle an overarching lack of rest amid a draining travel schedule, Alex has continued to stress “sleep hygiene,” which includes shutting off devices at night to create a more relaxing environment.

“You look at players that want to play video games late at night. You're not sleeping. You're staying awake and it causes stimulus,” he says. “It's all these little things like that, that falls under sleep hygiene.”

Though Alex is reluctant to claim any credit, he’s no less of a leader in his field—and not just by setting an example with the Raptors. He’s drawn inquiries from his peers in other sports, and shared his expertise with students at the annual Sports Business Classroom in Las Vegas, which runs concurrently with the NBA Summer League.

This year, he partnered with Warren LeGarie and Albert Hall, the founders of the Las Vegas Summer League, as well as Dr. Randa Bascharon, a world-renowned orthopedic surgeon, to host a cadaver lab for trainers, physical therapists and aspiring sports medicine professionals at Goode Surgical in Henderson, Nevada. Alex brought in two physiotherapists with whom he’s worked closely—Amanda Joaquim of the Raptors and Danielle Langford of Fortius—to present on the inaugural theme of shoulder injuries.

Even Alex, in all his wisdom and expertise, was taken aback by what he saw there.

“The amount of trauma to a joint that's undergone surgery—with the grinders going into the joint and cleaning the joint—you're totally traumatizing the joint,” he says. “It's no wonder the joints are swollen when they come out. That kind of blew my mind a little bit.

“Also, not just that, but how skilled these orthopedic surgeons have to be in working in such small areas, and without traumatizing the joint, with as little trauma as possible to the joint with the grinding. It's really quite remarkable, quite frankly.”

Next year, Alex will lead a lab focused on the ankle. In the meantime, he’s working to share the blueprint for all-around success that he implemented in Toronto with the public. He’s partnering with Danielle on Core A.I.M., a resource for integrating athletes, coaches and trainers the way he has with the Raptors.

Alex McKechnie

This past July, Alex co-hosted a cadaver lab focusing on shoulder injuries in Las Vegas, concurrent with the NBA Summer League. (Courtesy of Alex McKechnie)

In an industry as guarded as sports medicine, Alex may seem like he’s giving away trade secrets. He insists, though, that while his methods for success can be imitated, duplicating them is an entirely different endeavor.

“You can build these wonderful complexes and different places and build out all that you want to, but if you don't have the right prescription, it doesn't work,” he says. “And it's the ability to dispense the prescription that becomes the art.”

Few of his peers have painted as many masterpieces as Alex has. As he approaches 46 years in sports medicine, and his sixth season as part of an NBA title defense, he looks ahead to an exciting future for his field.

Where analytics are blended into his work to help identify movement patterns. Where neuromotor programming and virtual reality training become more prominent components of athlete performance. Where the players demand as much knowledge, education and direction from sports scientists as they do from their coaches. Where fatigue and recovery become not just talking points, but areas of focus for practitioners and organizations alike.

And, of course, he wants to win again, and help the Raptors do so by keeping their players healthy.

But even without another ride-along with the Larry O.B., Alex’s legacy is already secure. He may well wind up in the Naismith Memorial Basketball Hall of Fame someday for his contributions to the sport.

Not just the championships he’s been a part of—though those certainly matter—but the extent to which he’s brought greater respect and appreciation to his profession, both within organizations and among the general public.

“I think what we've managed to do here is change the face of the NBA a little bit in the sense that we've built this platform [for integrated sports science], certainly in Toronto, and I know a lot of other teams have built similar platforms over the course of the league,” he says. “I think we were one of the first teams to do it, but we're right here.

“I think, to have done that and to have maybe changed the face of how people look at our roles within the organization is a big factor.”


Josh Martin is the Editorial Director of CloseUp360. He previously covered the NBA for Bleacher Report and USA Today Sports Media Group, and has written for Yahoo! Sports and Complex. He is also the co-host of the Hollywood Hoops podcast. Follow him on Twitter and Instagram.