Playing through the pain for athletic gain

As the final minutes of the fourth quarter slip away, senior Andrew Beach sprints down the field, cradling the lacrosse ball in his stick and searching for an opportunity to score against Sherwood on May 1 of last year. Without warning, an opponent decks him from the side, sending Beach into a flip. His flight ends abruptly when his skull smashes against the ground. He lies motionless on his back.

Just four days before, Beach, a junior at the time, had suffered a concussion in a game against Magruder. This second episode resulted in two broken ribs and another concussion, bringing his season to an end.

For Beach and many other dedicated athletes, health often becomes secondary to fulfilling team obligations. According to a 2004 report from the National Safe Kids Campaign (NSKC), overuse injuries - which occur over time from repeated motion and can stem from poor training or inadequate healing after an injury - are responsible for nearly half of all sports injuries in middle and high school students. At Blair, loyalty to the team and the need to compete keeps many students playing a sport even when injured, sometimes leaving themselves vulnerable to long-term complications.

Pushing their limits

Beach's doctor suggested that he take seven to 10 days to recover from his first concussion. But Beach decided to sideline his health instead of being sidelined in the Sherwood game because he "didn't want to let down the team." The potential danger of failing to recuperate from a concussion did not faze him until the second injury.

If an athlete isn't fully healed after a concussion, a second concussion can result in permanent brain damage, neurosurgeon Brian Hunt says in a 2003 Pediatric News article. The NSKC states that brain injury is the leading cause of sports-related death.

Fortunately, Beach's injuries did not cause permanent damage or prevent him from playing on the team this spring, thanks to intense physical therapy. But his coach, social studies teacher Robert Gibb, worries that too many athletes like Beach "try to soldier on" and ignore the risks. "It's one thing to get bruised and beat up, but it's another thing to get a severe injury," Gibb says. "It's a high school sports event, for God's sake."

Security guard Jeffrey Seals, coach of the varsity football team, agrees that it's better to be on the safe side when dealing with injuries. "If it could seriously damage them for life, then it's not worth it," he says. "You're not helping the team anyway, because you're not giving 100 percent."

Seals realizes that his players are not always honest about the pain they endure because of their competitive natures. Senior Michael Wright seriously pulled his hamstring during a game against Springbrook on Sept. 18 of last fall, but he chose to "suck it up," accept the risks and hide some of his pain from his coach. Although he only returned to play briefly, he contributed to a key offensive play.

All Blair coaches, including Gibb and Seals, require a doctor's note in order for a seriously injured athlete to return to play. But in borderline cases, this crucial decision may be left to the athlete to make.

A will to win

When senior Erica Nowak first sprained her ankle during a lacrosse game in 2002, she returned to play two days later against her doctor's warnings. Having neglected her injury, though, she now suffers the painful consequences.
As a captain of the girls varsity lacrosse team, Nowak justifies her decision to play with a strong desire to win. "I didn't really listen to [my doctor's] advice," she admits. "Winning was more important."

Three years after the injury, Nowak's weakened ankle now requires care and attention in order to avoid further damage. She attends weekly physical therapy sessions, wears a supportive brace and must routinely ice her ankle after exercising.

Although Nowak admits that the pain can still be unbearable at times, she says her doctor's suggestion to stop playing is even less tolerable. "It's gotten to the point where I need major physical therapy and maybe even surgery," says Nowak. "But as much as I appreciate what the doctor tells me, sitting out the season is really not an option."

English teacher Michael Horne, the girls varsity lacrosse coach, takes Nowak seriously when she complains about ankle pain while playing. He notes that the athletic department's primary concern is the health of the athlete. "We try to err on the side of caution without over-limiting the player. We make decisions in the best interest of the player," he says.

James Gardiner, an orthopedic surgeon who specializes in sports medicine at the Metro Orthopedic and Sports Therapy (MOST) center in Silver Spring, acknowledges the challenges of balancing health and the demands of the game. "The athletes have a responsibility to themselves to recognize their symptoms, and physicians have a responsibility to treat their patients honestly," he says. "As long as they can return to the sport without jeopardizing their health, we encourage them."

As coaches try to keep their players safe, they may need additional resources to help prevent and treat injuries.

Injury expertise

The NSKC estimates that half of all organized-sports related injuries among teenagers can be prevented with appropriate conditioning. Gardiner points out that he treats overuse injuries almost every day at MOST, the majority of which are a result of inadequate preparation in the off-season. Gardiner says that "pre-habilitation" - stretching, strengthening and other conditioning in the pre-season - is the "best way to diminish the injury rate" during the season.

Blair is offering a new health elective, Sports Medicine and Management, which teaches a similar philosophy. Physical Education teacher Louis Hoelman, who created the course, teaches students about the anatomy and physiology of the joints, muscles, ligaments and tendons so that students can learn how to prevent, care for and rehabilitate injuries. The ultimate goal of the course is to certify students in CPR and first aid, so that they can volunteer as certified student athletic trainers for all of Blair's sports teams. A student trainer is knowledgeable about sports injury prevention and can assess and treat certain types of injuries.

Junior Adam MacLeod, who is currently enrolled in the course, recently began working as an athletic student assistant for the varsity girls lacrosse team. In addition to offering students community service hours and valuable hands-on experience in athletic training, the new program benefits the team's performance. "It lets the coaches focus more on the game," MacLeod says. "I deal with the injuries, and they coach the team."

Speaking from experience as the varsity girls softball coach, Hoelman feels that all of Blair's teams could benefit from having access to a trainer. "High-school athletes are so young that their bodies can recover quickly," he says. "But if athletic injuries aren't treated right away and handled properly, [athletes] can be haunted later in life."