Courtesy of NYU Langone Health
Buying Sandlot recently caught up with former NCAA chief medical officer Dr. Brian Hainline, who expanded his role at health and wellness support platform Koomba
Hainline — also a former USTA president — will now serve as the startup’s senior advisor for health, safety and governance.
Koomba connects families with dietitians, sports psychologists and mental performance coaches; it also works with collegiate athletics departments.
Here is the lightly edited Q+A from our interview:
What does the new role entail, and why did you decide to take on a larger role at the company?
When I first got involved with Koomba and it was more of a peripheral involvement. I thought it was a very interesting company, interesting concept. I met a lot with Greg and Max and then later with Russell. With a lot of startups people have ideas, but they were really starting to operationalize their ideas and making an impact. And then I started taking a deeper dive and wanted to be certain that Koomba was differentiating itself. It's not a medical advisory company.
I've been very involved in, especially in the last 15 years, in governance issues, in sport, in the public good, working with the NCAA, the USTA. I thought I could offer much more to Koomba by way of governance and ensuring that their platform focused on health and safety, but not medical care per se. There's a differentiator.
And I also saw that Koomba could really make a difference in the youth sports market, especially when we're talking about developmentally appropriate activities. There's just an absence of guidance in that entire market. So it was a lot of factors coming together, seeing that I could offer more to the company, but seeing that the company was really starting to take off and could offer a lot more to the public good, especially in the domain of youth sport, which I have very serious concerns about.
Let's talk about those concerns. What kind of concerns do you have right now?
When I was thinking about taking the (NCAA) job, I wasn't certain I wanted it. But the NCAA made a commitment -- I really believed at the time that out of all the amateur and professional national governing bodies of sport in the country, that the NCAA could probably oversee change better than any other NGB. And we were the first, the NCAA was the first to have a full-time chief medical officer. Now virtually every NGB does.
So the timing was really great, but now look at what's happening. The NCAA is increasingly professionalized. I'm not making a judgment that that's right or wrong. It's just a fact. And NIL is really not just trickling down -- it's coming as a waterfall into youth sports. There's an increasing pressure to professionalize youth sport, which means that once you do that, you kind of can possibly move away from an ethical lane and a moral lane.
I'm not saying that that has to be the case. But when there's money involved and incentive to make more money, that's always the possibility. And then from a parent's point of view, parents living vicariously through their kids, there's a possibility that their young child is gonna become a millionaire through NIL deals. And that pathway gets really pushed for the sort of short-track college pathway.
The other thing which is really important in our country that people don't realize -- we're one of the few countries in the world that to be a coach, all you have to do is hold up a single and say, “I'm a coach.”
You don't require thousands of hours of education like in Europe. And we're also one of the few countries in the world that doesn't have a minister of sport. So we don't have any central overseer of sport. It was supposed to be the U.S. Olympic and Paralympic Committee when we go back to the Ted Stevens Amateur Sports Act, but that never materialized. And so I see Koomba when we're talking about mental wellbeing and mental performance and nutrition, being really the bedrock or the foundation of what's really important in youth sports.
I really believe that they can not only do it right, but they can do it with an ethical foundation. And those are the things that I'm very interested in with the youth sports landscape. After all, we're talking about the most sacred asset on this planet and that's our children. That is another reason why I really stepped up because I saw that Koomba could really fill that space not only with great content, but with an ethical voice.
We see a lot of youth sports platforms are beginning to offer things like mental skills training. That makes us recoil a bit because anything involving a kid's mental health and their brain should have a professional involved. What is your reaction and can you speak to how important it is that people who work in the space be properly credentialed?
It's a great point. And we have to differentiate a licensed mental health provider who's really taking care of mental health symptoms and disorders. And so that's a medical relationship, which is what Koomba is not. And also licensed individuals who really understand what mental performance and sort of mental toughness, mental well-being really means. And the one thing that we're really emphasizing with Koomba.
I'm going to take another step back. Every one of the national governing bodies that are part of the USOPC, they're signatories to what's called the American Development Model. A lot of people don't realize that. And the American Development Model means that at every age and at every level of your ability, you should be only doing what's developmentally appropriate. How Koomba is modeling itself is that for mental preparation, mental performance, mental well-being, you do what's developmentally appropriate mentally, emotionally, socially, physically, I believe even spiritually.
Spirituality really has to do with culture, not religion per se. You take all of those factors and you have people who really are experts in what's developmentally appropriate. Then we're in the business of human development rather than just trying to fast-track someone into being a superstar. Because when you fast-track into being a superstar or someone's living vicariously through you, the outcomes very often can be really negative.
What do you think leagues organizations can do to sort of get that knowledge out there more to families and to athletes beyond all these fragmented NGBs magically pulling together under the USOPC banner?
I think there's a couple pathways. Everything with Koomba is going to be centered around the ADM. That's really the foundation. That messaging with anyone who's working with Koomba is going to go out. It's going to be consistent with the ADM. The other is for national governing bodies to step up and say, what does the ADM mean to them?
College sports have obviously become more professionalized. But it seems like in a way youth sports is almost -- it's not like the old college model is shifting to youth sports. It feels like youth sports is just skipping right over that too and going right to professionalization. Would you agree with that?
Yes, unfortunately. That's been happening for a while. And again, one of the reasons that's happening is because there is no central oversight. The NCAA -- and the reason I was ultimately excited to go there -- really does have central oversight. And I think that still is there at the NCAA from a health and safety point of view. But once you add the money incentive -- again, I'm not saying it's right or wrong, it just is. We have to figure out how you work that into the health and safety model as well, because that's always what's paramount.
Koomba has dieticians on the platform. When you look at youth athletes -- mental health issues or challenges vs. physical challenges like eating disorders, is it all the same level of concern or do you think one area is a bigger concern?
I think it's all a concern. I'm a big believer in what's called energy management. And it's not an original concept from me. Dr. Jim Loehr, a very famous sports psychologist talks about it. And so how do we manage our energy day to day, like physical energy? That has to be managed.
I don't lift weights in the same group every day because there has to be a recovery process. That's something we call periodization. How do I manage myself emotionally? If I'm not really taking care of my emotions, that's going to manifest itself physically. That's very clear. The mind and body is on one pathway. You have to take care of your emotions and then what we eat is a huge part of that. And a lot of times the way we eat we're actually self-medicating. You know, you can eat a salad if you're really stressed out. It's probably not going to help your stress, but you put in like a nice McDonald's hamburger with some ice cream and sugar and you're less stressed within two minutes.
That's why I think it's really so important to talk about the eating not just as, "you should eat these vegetables and this," but eating as a way of being. A very important concept in sport is not just eating disorders and disordered eating, but what we call relative energy deficiency.
If you are training, and you are not giving yourself the right nutritional fuel, you start becoming relatively energy deficient. That actually is associated with anxiety. It's associated with depression. It's associated with poor performance. So all of these things interlink. And what's really important is just to say, how am I really building up my foundations, my building blocks, so that in the human development world, I'm going to be developing in a better way.
If you're a parent and your child is playing at a high level, struggling to some extent, is there a way for a parent to identify what is a performance coach, performance skills issue vs. a sports psychology issue?
There's not an easy way. One of the things that Koomba is doing, and this is part of how we're working with the live individuals who are working with them, but it's also really part of the algorithms too, there are ways when you have performance issues that there may be red flags that come up.
Maybe it's an overly simplistic example, but say every time Mary is on the free throw line and it doesn't really matter, she always makes the free throw. But when it really matters, she always misses. You could call that performance anxiety unless she believes that she doesn't deserve to make the free throw, that her self-worth is such that she doesn't deserve it.
That may be because of something else. It may even be a prior traumatic event. And so it's understanding when you have these red flags that it's not simply you suck it up or that you tough it out, that sometimes it really is pointing to something else. I think the performance anxiety, the performance issues, the mental health issues, they're all kind of on a continuum. And we can't just artificially separate them and say one is A and one is B. You have to know when you sort of need to get more professional help from a licensed mental health provider.
Do you have any thoughts on democratizing mental performance?
IWhen we talk about democratizing things, we're talking about democratizing access to health care, democratizing access to good food, democratizing access to education.
We're in a country where we have somewhat of a safety net, but we still have what, 60 million people without health insurance? We still have millions of people who don't have access to adequate nutrition. And when we're talking about the mental health space, it's even worse. We don't have enough licensed mental health providers, and we don't have enough really good algorithms out there if you will or models for helping everyone. Yes, absolutely we should. That is why we need a minister of sport.
We had a surgeon general, Dr. Vivek Murthy, who was the prior surgeon general. He really was trying to democratize the idea of understanding social media, its potential dangers and as plus, but also understanding the concept of loneliness.
He wanted everyone in the world to understand that. But he's one person and the messaging wasn't always uniform. I think if we were in a proper world -- again, this is not simply a political statement -- we would understand that we need equal access for all of those sorts of things.
Where should it come out? I think in the school system.
What we've done is we've progressively segregated physical activity away from our public schools and replaced them with state-sponsored tests that don't tell you anything and don't do anything. And if we had real physical activity so that every child in America has at least an hour a day and as part of real physical activity, you're understanding the mind, body, social continuum of physical activity -- well, there you have it.
It might seem simplistic. And if that's not going to happen, I think there is another solution in our country, and that's the after-school programs.
As an example: In New York City where I am, there is one group called New York Edge. They provide afterschool programming to over 20,000 underserved kids. Most of them end up going to college. In those programs in the witching hours of 3-6 p.m., you're learning sport. You're getting academic help, You're learning about good self-care, which really gets to the heart of your question. What is good self-care? Well, it's good mental care, emotional care, nutritional care and so on and so forth.
Koomba is stepping in and it's one model, but how do we get that to everyone? I think that's a very, very important question for all Americans to answer.
I think there is a good chance we will see some form of federal subsidization for collegiate Olympic sports at some point. Could that be what leads to a true minister of sport position emerging?
Well, sometimes I have reluctance about federal systems as well. You have to really get it right. Where would it fit under? HHS? I don't think that would be, in my opinion, a good idea.
We have to think outside of the box because there is a fear. I mean, look, the SEC and Big Ten could just decide they're going to go do their thing and not be part of the NCAA. And we have to understand that 80% of American Olympic athletes, their training ground is at universities in the NCAA.
I was just at a U.S. Tennis Association meeting. I'm their immediate past president and still on the board. I said, "can the USTA come up with alternate models where maybe we're funding collegiate tennis competition if the current model goes away? I think the NGBs have to be thinking that way, but a lot of NGBs don't have enough money to do that. What you're saying is a grave reality. We have to start imaginatively thinking how we're going to address that.
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