Jan 29, 2015
Q&A with Steve McCauley

Steve McCauley, LAT, ATC, CSCS, is Head of Health Services for Wynn Las Vegas. He currently provides athletic training services for the 85-member cast of the popular acrobatic show, Le Rève. In this interview, McCauley shares his thoughts on working in the entertainment industry and talks about what it’s like to provide coverage for world-class performers.

Training & Conditioning: How did you get into athletic training?

McCauley: I graduated from California State University at Northridge with a bachelor’s degree in Public Health and was accepted in the Athletic Training program, following my football career at Northridge. I became a certified Athletic trainer in 1990. I became a certified strength and conditioning specialist in the early 1990s.

Why did you choose to work in the entertainment industry?

I have been involved in performing arts my entire life, first as a performer then as a health care provider. When the opportunity to provide athletic training services in the performing arts setting presented itself, I took it and have been involved since that time. The opportunity I refer to happened shortly after the Arena Football team in Las Vegas folded. I was asked to replace a physical therapist on a show called EFX at the MGM Grand. I was asked if athletic trainers could provide the needed services in a cost-effective manner, I thought we could and ended up staying as the primary health services provider for seven years until the show closed. I have developed the health care services for “Lord of the Dance,” “Notre Dame de Paris,” “Storm,” “Mamma Mia,” “Blue Man Group” and Hans Klok’s “The Beauty of Magic.” I did this as the outpatient services manager for a local hospital in Las Vegas, until the hospital decided to terminate all outpatient therapy services. I then became an Athletic trainer for Cirque du Soleil on a show called “Mystere.”

How and when did you start working with Le Rève?

I became the head of Health Services at Wynn Las Vegas in 2004. When I was doing “Mystere,” I learned about the opportunity to work with Franco Dragone in the creation of Le Rève at Steve Wynn’s new hotel in mid 2004. I was eventually selected to be the head of Health Services and given the opportunity to create a program on a multi-million dollar show.

Describe your staff.

I have three full time employees. One is an athletic trainer and a physical therapist, another is an athletic trainer and massage therapist, and the third is an athletic trainer and strength and conditioning specialist. I have three on-call staff consisting of two massage therapists and one athletic trainer. I have also contracted with a local Pilates studio to provide instructors to the theater each day, as well as allowing performers access to the studios for personal training. What does a typical day look like for you?

I start the day at noon, when I treat performers who are not currently in the show. By 4 p.m. we are treating at full capacity. I also direct all workers’ compensation processes and make all doctors’ appointments and ancillary health services appointments for the performers. I am responsible for communicating the performers’ health status to management and working with them to develop plans so that the show doesn’t suffer. I am at the theater from noon to 11 p.m., five days per week. While I do not work in the theater on my off days, I am still working with the physician groups and insurance groups to facilitate care for the performers. What areas do you concentrate on when designing training and prehab programs?

When they are hired, each performer is given a comprehensive evaluation. Based on that evaluation, we develop various programs, including those designed to improve the performer’s strength, cardiovascular health, and flexibility, as part of our goal to ensure performers stay as healthy as possible. It is not possible to describe all the conditioning modalities and techniques we employ, but suffice to say that in addition to using well-known and demonstrated conditioning principles, many of the techniques are developed at the theater and are specifically designed for the acts in the show. These conditioning programs are so valuable that each performer’s program is personally monitored by our staff to ensure proper technique.

What are the most common injuries performers incur?

Due to the nature of Le Rève, injuries sustained to the upper extremities are the ones we see most often–specifically the cervical spine and shoulders. Sprains and strains account for over 60 percent of the total injuries incurred. Other common injuries are related to trauma, such as lacerations and fractures. Any recent rehabs that stand out in your mind as being extraordinary or unique?

The nature of the show demands that we be as creative as possible, since the requisite physical demands are far beyond the ordinary. We have seen the most amazing progress of two performers who sustained potential career-ending and life-threatening injuries. I have never seen two athletes return to full duty after sustaining these type injuries. I was then, and continue to be, in awe of their efforts. Do you work with any other performers or athletes?

Well to me, performers are athletes so the answer is, “Yes, I do.” I currently work with former performers, as well as performers who do not have access to daily health care, or who might be in a show that doesn’t offer insurance to its performers. I am able to do this through a company I created called Athletic Healthcare, Inc. Through this company, I can assist in providing necessary services to performers in small shows here in town at very affordable prices. This was the sole reason for the creation of Athletic Healthcare. What’s your favorite part about working with performers?

As I stated before, performers are athletes. And being a former college athlete, I have a sense of what they are going through at various times. I am always amazed at how these athletes can put it out there each night, without showing the stress or strain they feel. In a regular sporting event, we are always drawn to the athlete who is struggling with an injury or illness. We find that to be above the call of duty, showing they “reached for something extra.” The performers I work with can’t show their pain; they can’t grimace while on stage. These folks have to smile no matter what they feel. To me, getting to work in that environment provides an added level of emotional intensity and is at times at “playoff” level. I get to do that daily, and that’s the best part. In addition, the relationships with performers and staff I have developed over the years are a special element for me. Seeing a performer go from a young non-English speaking acrobat to a mature well-spoken performer is a special thing. What are your biggest professional challenges?

Time management is the biggest challenge for me at Le Rève. Being responsible for managing and providing healthcare for more than 80 performers is a task that needs daily attention. However, describing the profession of athletic training and what we do and how we do it is always a challenge. In performing arts, the understanding of our profession as it relates to various departments in a show or management company continues to be poorly understood. This is particularly critical when developing healthcare for a show or company that has no previous experience with our profession. What are the biggest misconceptions people have about what you do?

Some people believe we are not health care providers–or that we are poorly trained health care providers. Worse yet is when we are perceived as personal trainers or assistants to a physical therapist. This results in our being denied the one aspect that is essential to what we do, which is being the on-site healthcare authority in the absence of a physician. If the athletic trainer is unable to obtain that recognition within a cast or group of athletes, he/she becomes ineffective in the delivery of healthcare. What have you gotten out of the experience working with Le Rève? How has it affected your athletic training philosophy?

What I now know without a doubt is that the athletic trainer is well equipped and should be the primary choice as the healthcare provider for this setting. Our educational background and training, unlike that of any other allied profession, allows us to deliver comprehensive healthcare to athletes and performers, which in turn allows them to return to the stage faster than with any other provider. I do not believe my personal philosophy has changed, but my experiences here at Le Rève have led to a stronger conviction that in fact this profession is the most appropriate one for this setting.

How do think this experience will affect your career path?

My experience at Le Rève has demonstrated that every performer/athlete needs to have access to daily care from an athletic trainer. The challenge is how to make this happen in a cost-effective manner for the performer and the company. I will continue to work toward this goal, and it is my hope that other athletic trainers seeking a change in their careers seek out these opportunities.

What kind of feedback have you received from the performers and management group of Le Rève?

Entirely positive. We have shown various groups like insurance companies and hotel management, that athletic training is a cost-effective means of delivering healthcare to performers, who are typically the most frequently injured people in the hotel. We have received positive feedback from the non-orthopedic medical community. We are able to assist them in the recognition and diagnosis of conditions and illnesses, thus allowing doctors to deliver specialized health care in a more effective manner. But most importantly, we received positive feedback from the performers themselves. To me, this feedback is vastly rewarding because they are the ones who benefit from our services. It is a pleasure to see an athlete perform better or at all as result of our work.

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