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An estimated 3 million to 4 million Americans suffer sports injuries each year. Many of the injuries can be prevented, and innovations in treatment can help athletes recover faster and more completely than ever before.

Torrential rain didn’t stop Matt Bunsey from having the night of his life. On Friday, September 6, 1996, the star football player for St. Ignatius High School in Cleveland, Ohio, scored five touchdowns and rushed 341 yards, setting a new school record. It seemed nothing could stop him.

Just a few weeks later, though, as the team prepared to play its longstanding rival, something did stop Matt: an ache in his right leg. “I just couldn’t bear the pain,” Matt says. X-rays showed a stress fracture (partial break) of the right fibula (small lower leg bone).

Matt didn’t want to miss any games, especially in his senior year. But further jarring could cause a full break or do permanent damage. So he hobbled around with an air cast for the next four weeks.

“I needed to get it off as soon as possible so I could get back to the playoffs and then try to get to the ultimate goal of the championship game,” Matt says. He didn’t just sit on the sidelines, though. He worked out regularly to maintain upper body strength. When his doctor gave the go-ahead, Matt began leg exercises. When the cast came off, he trained to get his speed back.

Matt made it back just in time for the playoffs, and St. Ignatius went all the way to Ohio’s 1996 Division A championship game. The team lost that final game, but Matt was a winner. He paid attention to his pain and recovered from his injury.

Too Many Injuries

Sports injuries hurt between 3 million and 4 million Americans every year. The American Academy of Orthopaedic Surgeons estimates the financial cost of those injuries at more than $18 billion. Yet that doesn’t reflect the tremendous personal costs. Some athletes are lucky enough to lose only weeks or months from play. Others see hopes for a promising sports career dashed. Still, other victims are paralyzed or die.

Last March, one issue of USA Today reported no less than 15 injuries to major league baseball players during spring training, including the Indians’ Omar Vizquel, the Tigers’ Phil Nevin, and the Mets’ Rey Ordonez.

And in basketball, hip and ankle injuries caused the Houston Rockets’ Charles Barkley to miss more than two dozen NBA games last season. “What can you say?” said Barkley. “You can’t blame anybody for it. Stuff just happens.”

The good news is sports injuries can be prevented. Even if an injury occurs, treatment breakthroughs mean faster and fuller recoveries than in the past.

How Injuries Happen

Trauma is the most obvious type of sports injury. In pro basketball, Sacramento Kings forward Brian Grant hurt a leg tendon in a March 1997 collision with another player. At the 1996 Olympics, gymnast Kerri Strug landed wrong on her next to the last vault, badly spraining her right ankle. These injuries are painful, but the athletes can and do recover.

Other traumatic injuries are pure tragedy. Head injuries have paralyzed or killed athletes in such diverse sports as football, soccer, hockey, swimming, and cheerleading. Actor Christopher Reeve’s 1995 fall from his horse while jumping hurdles injured his spinal cord and paralyzed him.

But not every injury happens all at once. “It could be something building up for years,” explains Andrew Denlow, who was a star baseball player and pitcher throughout high school and then at Washington University in St. Louis, Missouri. In his junior year in college, Andrew underwent surgery on his shoulder for an overuse injury, an injury caused by repeated physical stress over time. Andrew recovered about 90 percent mobility to his throwing arm, “which is good,” he admits. But, he says, the problems meant a major league team that had aggressively recruited Andrew refrained from making an offer. “That held me back and ruined my shot at being a pro ball player.”

Different sports emphasize different skills, so “typical” injuries vary. Shoulder and elbow injuries occur most in baseball and tennis players. Knee injuries, shin splints, and foot injuries are common among athletes who run a lot, either in track or as part of a sport like a basketball or a soccer. President Clinton’s surgery last March repaired a torn tendon that was likely related to an overuse injury called runner’s knee.

While different parts of the body are affected, many injuries fall into categories. A fracture is a broken bone. Muscle strain is a muscle fiber tear. A sprain is from stretching or tearing of ligaments, “ropes” that hold bones together. Tendinitis is inflammation of tendons, tissues that connect muscles to bone.

Innovations in Treatment

When an injury occurs, proper treatment is vital to recovery. And new methods of treatment have had a tremendous impact on recovery rates. If sophomore high school football player Chris Meissner had broken his right thigh bone in 1975 instead of 1995, he’d have spent six months in a half-body cast. Instead, doctors inserted a three-eighths-inch metal rod through the bone, eliminating the cast altogether and enabling Chris to get around on crutches. Surgeons removed the rod earlier this year.

Sports medicine specialists constantly search for more effective ways to help patients heal more quickly. A new experimental treatment stimulates bone healing with protein injections a sort of “bone glue.” For other types of injuries, laser surgery and cartilage transplants are showing good early results.

Many athletes now start rehabilitation exercises much earlier than before. “For certain types of injuries, the early motion causes better healing,” explains orthopedic surgeon James Williams of the Cleveland Clinic Foundation.

Other exercises guard against losing benefits of prior training and conditioning. Certified athletic trainer Hilary Hewkin encourages recovering athletes at St. Augustine Academy in Lakewood, Ohio, to warm up with the team and work on specific drills in addition to their rehabilitation exercises. “It’s especially important for these athletes to feel they’re still part of the team,” she says.

One time-tested method that continues to be the primary treatment for many common injuries is popularly known as RICE. Rest the injured area. Apply Ice wrapped in a towel or cold pack to relieve inflammation and pain. Use Compression with an elastic bandage or sports tape to reduce fluid swelling. Provide Elevation to reduce excess blood flow to the injured part of the body.

Heat sometimes relieves stiffness days after swelling is gone. Most times, however, the best choice for pain is ice, not heat. “Pain is almost always caused by swelling,” Williams says, “so ice is certainly the way to go.”

Now, more than ever, athletes need to follow directions from doctors, therapists, and trainers. And despite all the sports hero stories, teens shouldn’t try to play while they’re still hurting. Risking reinjury helps neither them nor the team.

Prevention Is the Name of the Game

Preventing injuries is the ultimate goal. “If we can keep an injury from happening, we can save the athlete a lot of trouble and rehabilitation time,” says Dale Blair, a certified athletic trainer at Wenatchee High School in Washington State.

Medical screening exams can catch potentially life-threatening problems. Beyond this, being in good physical shape is imperative. “A lot of times people say `I’ll play a sport to get in shape,'” says Blair. “It really should be the other way around. You should get in shape to play the sport.”

Flexibility, strength, and endurance are key. Even in the off-season, athletes should maintain overall fitness. As playing season approaches, they should start sports-specific training. Williams, who also holds a degree in sports management and has coached numerous sports, says, “For almost any sport…you can’t be too flexible, you can’t be too strong, and you can’t have too much endurance.”

But that doesn’t mean you should overtrain and overload your body with more than it can handle. A steady progression is essential. Build up gradually with a training program that keeps sports fun. If the goal is to run 10 kilometers, start with one or two. Add distance over time. Too much too soon is almost always a formula for getting hurt.

Years ago, a teen athlete might have played softball in the spring and volleyball in the fall. Now many sports are played year-round. Other young people play multiple sports simultaneously, with a hockey game on Friday and a soccer match Saturday. Without time to recover from repeated stress, athletes often develop overuse injuries.

Whatever your sport, use proper safety equipment. For example, using wrist guards, helmets, and knee pads could help prevent thousands of in-line skating injuries each year. Proper shoes with good tread can help prevent sprained ankles and foot injuries. Just remember–even the best protective equipment can’t make you invincible.

Strict attention to the rules of fair play and officials’ concern for safety conditions, in general, can also help prevent tragic injuries. Last year 500 athletes who’d traveled to Columbus, Ohio, from hundreds of miles around were disappointed when officials canceled the Midwest Scholastic Championship Regatta. Heavy rains the day before caused a strong undertow that would almost certainly have drowned any rowers who fell overboard. Going forward with the race just wasn’t worth the risk.

Always pay attention when participating in any sport, warns Erin Cramer, who’s served as the head athletic trainer at Thurston High School in Springfield, Oregon. “Lack of focus can put the athlete in dangerous situations.”

Getting Athletic Trainers on Board

Good technique can help athletes avoid countless injuries. Ask coaches and athletic trainers to show you safer, more effective ways to practice your sport.

Colleges and professional teams have had dedicated athletic trainers for years. Now teen athletes are benefiting from more high schools have certified athletic trainers on staff. Besides providing safety education and immediate first aid, trainers help athletes with rehabilitation from injuries. “By bringing the services to the school, kids can receive help every day,” notes Cramer.

But, adds Blair, many more schools need to bring trainers on board. “If more parents and students understood the value of having someone there on a daily basis, they’d start pushing for it.”

Raising the Red Flag

“Teenagers are susceptible to both peer pressure and pressure from a coach,” notes Dr. Stephen Pribut, a Washington, D.C., podiatrist on the faculty of George Washington University Medical Center. As a result, many teens keep playing even when they’re sore or tired. But pushing too hard can lead to injury and detract from effectiveness during competition. Learn your limits, and respect them.

Let pain be a red flag warning to get help. Athletic trainers can help keep minor injuries from becoming worse. For more serious problems, get a referral to a sports medicine specialist knowledgeable about the latest treatment techniques.

“Even if you don’t think it’s much, get an injury checked as soon as possible,” says Matt Bunsey. “The earlier you get attention, the quicker it will heal.”

Preventing sports injuries isn’t something other people can do for you. Each athlete needs to do the necessary training, use proper equipment, and follow medical and training advice. And each must commit to taking preventive measures seriously. “You can never really be too careful,” says Andrew Denlow. “Just like you have to give a car an oil change to keep it running, you’ve got to take care of your body the same way.”

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