The human body was not designed to play sports.
Our joints evolved to allow for great flexibility and range of motion, connecting bone to bone by remarkably strong, fibrous ligaments, and cushioning them with cartilage. But those tissues have a limited durability, and the constant wear and tear of competition takes a toll.
Injuries are inevitable. And so is rehab.
In contact sports like football and ice hockey, they come from violent collisions and take the form of dislocations, fractures, broken bones and torn ligaments. In aerobic sports like swimming, running and basketball, they come from regularly putting undue stress on joints for extended periods of time and take the form of sprains, pulls and tears.
All lead to an inordinate amount of time spent in a trainer’s room or doctor’s office.
They are the result of engaging full-force in unnatural physical activities — and they are accepted as part of the game.
“Most athletes realize that injuries are part of the sport,” said Adam Naylor, professor of sports psychology at Boston University and coordinator of the BU Athletic Enhancement Center. “But [how they cope with them] depends on how well-rounded they are.
“No one wants to be labeled an injured athlete,” Naylor continued, sitting in an office at the BU AEC before a seminar for runners, “so it’s easier to deal with being injured if you have something else to fall back on.”
However, in today’s increasingly specialized sports world, being well-rounded may be easier said than done. To compete at a high level, many athletes who years ago would have played several sports now concentrate solely on one. They play out the regular season, then move on to camps, travel leagues and even personal training.
This constant activity can lead to even more injuries, many resulting from simple overuse.
“[Overuse injuries] exist like crazy, because there’s no offseason anymore,” Naylor said.
Ultimately, athletes find themselves faced with a no-win situation: play and risk injury, or get passed over by those who will.
“Nobody really wants to think about [getting injured],” said Corey Lowe, a sophomore shooting guard on the BU men’s basketball team. Lowe, who recently returned to action for the Terriers after missing three games with knee bursitis, speaks softly and doesn’t offer much in the way of elucidation — uncomfortable perhaps because of the situation, more likely by the topic. “I guess injuries are always in the back of your mind.”
Knee bursitis is an inflammation of the bursa — a fluid-filled sac — that sits on top of the patella, or knee cap, and allows the skin of the knee to move smoothly over the knee cap during rotation. While painful, bursitis is not usually considered serious, and can be treated by rest and draining of fluid from the inflamed area.
“I had the same injury last year,” Lowe said, leaning back on a couch in the BU athletics office, “and I didn’t understand why this [episode] was taking longer.”
Lowe said there wasn’t much of a readjustment period once his knee stopped hurting and he got back on the court. The numbers bear that out — after scoring just seven points in 21 minutes at the University of Maine in his first game back, Lowe dropped a 23-point, three-assist performance in a full 40 minutes against the University of New Hampshire in Durham.
“You always want to get back as quickly as possible,” Lowe said. “I had a lot of coaches just tell me not to rush back” because the risk of aggravating it was too great.
While the loss of Lowe — the team’s leading scorer at 18.2 points per game — was a big one, the risk of re-injury was not worth bringing the star scorer back before he was ready.
For Lowe, whose injury only kept him out for two weeks and required mainly rest to rehabilitate, the hardest part of the process was forcing himself to sit still while his teammates ran the court in practice and in games. Lowe’s teammate, junior forward Matt Wolff, had a much longer road to recovery and — depending on when you ask him — still might not be all the way back.
After averaging 19 points per game as a senior at Walpole High, the Massachusetts native came to BU to play for his father, head coach Dennis Wolff, and had a solid freshman season. Wolff averaged 4.3 points and 2.3 rebounds in 29 games in 2004-05, and looked poised to build on that performance in his sophomore campaign.
Unfortunately for both Wolffs, Matt never got the chance. Four games into the 2005-06 season, Wolff was lost for the year when a University of Rhode Island player fell into his left knee, tearing the medial collateral ligament (MCL).
“I was shocked,” Matt Wolff said. “The way it happened, I wasn’t even really involved in the play. It wasn’t even really live action, the whistle had already blown and the guy just fell into me.
“So I was kind of like, ‘What if I wasn’t standing there’, and ‘[What if] I had moved,'” he continued, sitting with his elbows propped on his knees. “All those thoughts went through my head, you know, like, ‘Why me?’
“But then, I mean, I wouldn’t wish it upon anyone else. You just kind of have to . . . deal with it. You have a bit of a reality check and just kind of do it.”
The reality check for Wolff was that he would be out for at least a year after undergoing surgery to repair the injury. The MCL — one of four ligaments that help to stabilize the knee — stretches from the bottom of the femur to the top of the tibia, and helps to limit the range of motion in the joint. Because it is inside the knee, the MCL is typically injured when the outside of the knee is struck — as happened in Wolff’s case — forcing the knee to open wider than designed.
Surgery to repair a damaged MCL leaves the joint swollen and immobile for a period of several weeks, so Wolff wasn’t even able to begin his rehab until the Terriers were well into what should have been his sophomore season. Diligent work with team trainers gave him back most of his strength and flexibility, but then, in the 2006-07 preseason, he had a setback. Wolff re-injured the knee and missed another entire season.
“I think it’s more physical at first, trying to get over the injury,” Wolff said of the difficulty of coming back from an injury. “Once you’re healed or whatever, it starts to be more mental.
“I was out for two years trying to come back and having recurring problems . . . having to go back in for surgeries,” Wolff continued. “So in that case I was thinking about just trying to get my knee [healthy enough] so I could play again. For me [the physical] has taken a while, so I’m still trying to get my confidence back.”
One problem an injured athlete faces is the sudden feeling of isolation after he or she is used to the camaraderie of a team. “When I was injured, [I tried] to be around as much as I could” to keep everything as normal as possible, Wolff said. But keeping things normal when facing an unusual set of circumstances isn’t easy.
Being a part of the team when one isn’t on the floor is tricky.
“It’s hard, it’s real hard,” Wolff said. “When I was out for as long as I was out I wouldn’t speak up or anything like that, because I wasn’t contributing to the team and it wasn’t like I was going to come back that year and play.
“I was out and I knew I was out.”
For Wolff, there are two sides to rehabbing a serious injury.
“It’s pretty easy, as long as you’re willing, it’s easy to get your body back to being in shape,” Wolff said. “For as long as I was [out], I was able to put on weight that I needed to put on and get stronger. And then when you’re back practicing and [playing], the physical part comes kind of naturally. I would say it’s harder to get your mental aspect back to the way it was before you got hurt.”
And while Wolff admitted to talking to trainers, coaches and teammates about his injury, he said the mental aspect of rehab — regaining your confidence — has to come from within. It comes from getting back on the court, forgetting the possibility of re-injury and learning to trust your body the way you did before you got hurt.
“Teammates help you, but a lot of the stuff you have to do yourself.”
Much of the work sports psychologist Naylor does with athletes is aimed at increasing their “general awareness.”
Naylor told a story of a session he held with a high school team.
“I asked them, ‘What does choking mean?'” Naylor said, “and they couldn’t tell me. They said, ‘Missing the big free-throw’ or ‘Messing up the game,’ and when I said, ‘No, what does it literally mean?’ they didn’t know.”
Naylor makes athletes think about their goals, forcing them to get specific when their general response is ‘I want to win.’ For injured athletes, Naylor’s goal is to get them to relax because reducing stress helps injuries heal faster.
“Rehab gets you able to walk, we get you able to run.”