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San Antonio Spurs coach Gregg Popovich, left, talks with forward Kyle Anderson during the second half of a preseason NBA basketball game against the Miami Heat, Saturday, Oct. 18, 2014, in San Antonio.

Darren Abate/AP

After the San Antonio Spurs won their fifth NBA title in June, demolishing the Miami Heat, the team's bosses left the roster almost completely intact in the off-season.

The team did make significant changes in the ranks of assistant coaches, but the biggest overhaul for the Spurs came in a rebuilding of their medical services department. In an effort to keep their aging stars healthy through another long basketball season, the ever-innovative Spurs searched worldwide for inspiration, including in Canada, where they consulted with the Toronto Raptors and hired Marilyn Adams of Vancouver as their new director of rehabilitation.

Adams studied at the University of Alberta and started her career as a physiotherapist in Whistler, B.C., in 1995. She has since treated Olympic freestyle skiers, snowboarders and triathletes, and in 2009 Adams began working closely with Simon Whitfield to prepare him for the 2012 Summer Olympics, when he was 37 – the exact expertise the Spurs sought.

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"She understands winning," Whitfield said in an interview. "She understands the commitment it takes. She understands the nature of the sacrifice required. She's a perfect fit for such a first-class organization. She knows how to keep an athlete fine-tuned."

Since Gregg Popovich's first full season as coach in 1997-98, the Spurs have won the most regular-season games in the NBA by a large margin, and are tied with the Los Angeles Lakers for the most championships (five each) in the past 17 seasons. San Antonio is considered one of the smartest organizations in all of sports, and constantly hunts for innovations.

The team is also noted for its hesitance to reveal details. A Spurs spokesman declined comment on this story and Adams was not available for an interview. "We keep all of our medical operations private," a spokesman said by e-mail.

Popovich has put a major focus on keeping his older players in shape. He limits the minutes of stars Tim Duncan, 38, Manu Ginobili, 37, and Tony Parker, 32. Duncan led all Spurs in minutes played last season, but his 33 minutes a game ranked a lowly 61st in the NBA.

The addition of medical staff – the Spurs made three principal hires – with specific expertise in preventing injuries and working with older athletes in physically tough sports such as rugby and snowboarding, as well as basketball, fits the team's style of strategic thinking.

It is all part of a quest to accomplish the one thing the team hasn't managed under Popovich: back-to-back championships. The Spurs have played in the past two finals, but lost to the Heat in 2013.

Last winter, in their effort to rethink their medical services, the Spurs visited with the Toronto Raptors and met the team's respected director of sports science and assistant coach, Alex McKechnie, a physiotherapist from Vancouver. McKechnie first made his reputation in the late 1990s, when he cured Shaquille O'Neal's chronic abdominal strains. A healthy O'Neal led the Lakers to three consecutive titles, and McKechnie worked for the team for about a decade before moving to Toronto in 2011.

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With the Raptors, McKechnie's techniques have helped slash the number of games players lose to injury.

The Spurs made use of another Canadian connection, too – Rick Celebrini, McKechnie's protégé. Celebrini has worked closely with Steve Nash through the point guard's career, and as chief sport officer at Fortius Sport & Health in Burnaby, B.C., he recommended Adams to the Spurs. Adams had been with Fortius since 2013.

"They poached one of our best, and we wish her well," Fortius founder Scott Cousens said.

And while no one wants to lose top talent, it was an endorsement for Adams as well as Fortius.

"I look forward to being able to compete with the likes of the Spurs," Cousens joked.

Mike Riddle, a freestyle halfpipe skier from Edmonton, first knew Adams had a special expertise in the summer of 2011, when he badly hurt his ankle training on a trampoline.

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"She just knows," said Riddle, who won silver at the 2014 Sochi Games. "She knows exactly what the issue is and treats not only the actual injury but everything connected to it – without you having to say or do anything. I went from a completely useless ankle that probably should have needed surgery to back on my skis in three months."

Like its international roster – two-thirds of the Spurs' players were born outside the U.S. – the club searched widely for their three new medical staffers.

Apart from Adams, the team hired Phil Coles, an Australian, as director of medical services. Coles previously worked for the Newcastle Knights in professional rugby in Australia, and with Liverpool FC in the English Premier League.

The third hire is Xavi Schelling, from Barcelona, who has worked closely with Serge Ibaka, the Congolese-Spanish star of the Oklahoma Thunder. Schelling holds a PhD in physical activity and sport, and has focused his work on issues such as prevention of and rehabilitation of injuries such as hamstring pulls, and tears of the anterior cruciate ligaments in the knees.

Schelling's title is "applied sports scientist" – which itself is still not commonplace in the NBA, even as sports science becomes a significant trend.

P3, a boutique sports science-"peak performance" firm near Los Angeles, has noted NBA teams stake big money on a handful of athletes they depend on heavily but: "most don't have a sports science and/or data-driven model for improving athleticism and decreasing preventable injuries."

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In Toronto, McKechnie's techniques have succeeded in slashing the number of games the Raptors lose players to injury.

On the assistant-coaching front – the other area of change for San Antonio in the summer – the Spurs sparked notice when they hired Becky Hammon. Hammon is the first woman with a full-time coaching gig in any of the big four pro sports in North America. The Spurs also went international when they hired Italy's Ettore Messina, a European basketball legend and one of the best coaches in the continent's history.

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