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If you’ve ever been slowed by aninjury, you know some conditionsgarner a bit more sympathy thanothers. Explain to a friend or

colleague that your sling, brace or crutchesare the result of a sports injury, and youmight earn a measure of respect. After all,you were out there putting your body tothe test.

That’s about the only silver liningwhen your favorite sport sends you to thesidelines. And it’s not just professionalathletes who suffer debilitating injuries.Anyone can make a costly cut on a gymfloor or twist into trouble on the golfcourse.

“Mostly we see the weekend warriortypes,” said Meryl Freeman, a physicaltherapist who manages outpatient rehabfor Rex Healthcare. “It’s people who areplaying softball or golf after not doing itfor a while. Most of what we see with backand neck injuries is years of bad posture,bad body mechanics, weak trunk muscles.You have to have pretty good strength todo most sports.”

Some injuries are relatively easy tocorrect. A few weeks of physical therapycan help a patient regain flexibility andrange of motion. Duke Sports MedicineCenter offers a comprehensive sportsmedicine clinic and physical therapy

program for the diagnosis, evaluation andtreatment of sports-related injuries for allathletes—from recreational toprofessional. Half of the staff andclinicians who care for patients at thecentter are board-certified in sportsmedicine or orthopedics, while others arecertified athletic trainers.

“Having all care providers, fromsurgeons to physical therapists available atone location makes communication a loteasier for everyone involved, especially thepatient,” said Tracey Koepke, seniorpublic information officer for DukeUniversity Health System. “All forms ofrehabilitation—from the patients’ first

health watchb y K u r t D u s t e r b e r g

Technology, Time and Therapy Get You Back in the Game

Sports Injuries

Sean ThomasHead Athletic TrainerNorth Carolina Central University

We wouldn’t have won five championships last year without Duke Sports Medicine. They keep our players on the field and in competition. They’re part of our team.”

For twenty years, Duke Sports Medicine has proudly served the student-athletes of North Carolina Central University—

including its 2006 CIAA championship football team. From mending injuries to cheering the athletes on at tournaments,

we’re there to keep them at their best and on their game. And we can do the same for you. Whenever you need us for

knee, shoulder, or other athletic injuries, give us a call—we’ll see you within 24 hours.

1-888-ASK-DUKE dukesportsmedicine.org

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treatment day to their last—can be foundhere. This greatly improves the patients’care and confidence as they progressthrough the healing process.”

Torn Rotator CuffBut even a well-conditioned athlete is

vulnerable to injuries, often far moreserious than sprains and strains.

One of the most common athleticinjuries is a torn rotator cuff, which refersto the group of muscles and tendons thatwrap around the shoulder. It’s typicallyassociated with the overuse pattern ofbaseball pitchers, who make the repeatedmotion of the overhead throw. If you’veever seen a photo of a pitcher in themiddle of his windup, you have surelynoticed the distorted angle of thethrowing arm. Just as it appears, thatposition is not a natural one for the body,and is a snapshot of a good news, badnews scenario.

“If you start early enough, youactually make some pretty significantadaptations to a young athlete’s shoulder,”

said Dr. Alex Creighton, M.D., anorthopedic surgeon at UNC Health Care.“It can give the athlete the ability togenerate more power, but it comes at theexpense of something else. Then they loseinternal rotation of their shoulder. Afteryears of doing that, you’re eventuallygoing to get into a problem with yourrotator cuff or with the labrum, which isthe lining around your shoulder socket.”

Fortunately, doctors have a betterhandle on rotator cuff tears and shoulderdislocations than they did 20 years ago.Because most of the injuries require onlyarthroscopic surgery, doctors are moreinclined to pursue an aggressive treatmenton a first-time dislocation.

“Through two or three smallincisions, we can repair the torn tissue—the part that keeps you from dislocatingagain—in a one-hour operation,” said Dr.Mark Wood, M.D., an orthopedic surgeonat Wake Orthopedics. “It’s an outpatientsurgery and there’s minimal pain. And therehab after surgery is identical to the rehabwithout surgery. So the advantages are

potentially huge.”Arthroscopic surgery also helps

decrease the risk of repeating the injury.“There’s a 50- to 90-percent chance theywere going to dislocate again and again,”Dr. Wood said. “In the old days, we waiteduntil they were debilitated by it and did avery large surgery. With arthroscopicsurgery, we can repair the torn tissue andput it back the way it was before it was torn,and we decrease the dislocation rate to 5 to10 percent.”

Anterior Cruciate Ligament (ACL) TearSimilar logic prevails with another

common sports injury—the ACL tear.This injury is often caused by sharp cutsmade in basketball and football, whenthere is severe rotational force during thepivot. Twenty years ago, ACL surgeryrequired a large incision, and the resultswere not very favorable. It often spelledthe end of a high-level athlete’s career. Butin the last 10 years, all that has changed.“The ACL is something we understand awhole lot better,” Dr. Wood said. “The

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incisions are small, fixation methods arestronger and outcomes have improved.”

One ACL mystery remains: thealarming rate at which women sustain theinjury. Female athletes seem far moreprone to ACL tears. “It’s almost anepidemic,” Dr. Creighton said. “It’sanywhere from five to nine times morecommon for female athletes from age 12to 20. The way a woman lands puts hermore at risk, like after they jump for ahead ball in soccer or go up for a rebound.(Due to) some of the things they respondto in space, they are more prone to havetheir ACL rupture.”

Dr. Wood said muscular anatomy has alot to do with it. “The way their musclesfire and the anatomy of the knee has beenshown to be different from men,” he said.“We think that may predispose some ofthem to increased likelihood of injury, butthose things are somewhat hard to prove.There’s a sharp increase in the number ofwomen’s ACL injuries in the last 10 years,mainly because there are a lot more womenparticipating in high-level athletics.”

Time to HealSurgical advancements come with a

warning. Operational techniques mightmake you new and improved—or at leastfull-functioning—but time is still a criticalfactor in making a proper recovery.

Dr. William Isbell, M.D., whospecializes in sports medicine and shouldersurgery at Raleigh Orthopedic Clinic andis the head orthopedist for the CarolinaHurricanes, cautions that there is no wayto shorten the body’s natural timetable.

“Despite our best efforts, there is adefinite time frame that some injuries take toheal,” he said. “Minimally invasivearthroscopic techniques, as well as moreintense rehabilitation programs, have allowedathletes to return to their sports earlier andearlier. Letting athletes return before thattime subjects them to further injury andmore down time. There is definitely a fineline between returning to play quickly andreturning to play too soon.”

Medical and training staffs oversee thereturn of professional athletes to theirlineup, but casual athletes must monitor

their own recovery. That means followingthe guidelines given to them by medicalprofessionals.

“I tell patients all the time that theirsurgery is only a small part of their recoveryfrom injury,” Dr. Isbell said. “Theirrehabilitation is one of the major keys to asuccessful recovery. Despite the time-intensive nature of rehab, it is worth theeffort to maximize and speed recovery.”

And if you find yourself in a physicaltherapist’s office, don’t hesitate to ask forhelp with your game plan. “Physicaltherapists educate,” Freeman said. “Forexample, for back pain patients, we willeducate them on proper lifting techniquesand proper ways to do their daily activitiesto help them avoid injury. But you also haveto know the limitations of your body andlisten to what your body tells you.” WL

Kurt Dusterberg is a freelance writer wholives in Apex. His book, “Journeymen: 24Bittersweet Tales of Short Major-LeagueSports Careers,” was published in July.

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