What recreational athletes should and shouldn’t learn from the professionals.
I am often asked how a certain player came back from injury so quickly. The answer is always multifactorial. Professional athletes tend to be genetically gifted, highly motivated, fit and healthy. Clearly professional athletes are genetically gifted in terms of their individual performance. Many of them probably do actually heal slightly quicker than normal but that is probably not the reason they return to play sooner. There have recently been studies showing that professional athletes are more likely to have a gene which is associated with a higher pain threshold. In fact in some sports like rugby league it may be one of the determining factors for success.
The degree of motivation existing for these professional athletes cannot be understated. The motivation to return to play is as much about the fact that their entire career i.e. all the training and sacrifices, all the time and effort has been focussed on obtaining and retaining this professional status, as it is, about the financial rewards and the celebrity status that might come with being a professional in a chosen sport.
Unfortunately most recreational athletes cannot replicate any of this to any great degree or hope to achieve these dizzy heights. There are however, a few things that the pros do that you should consider doing, equally there are others you should not try to replicate.
Things to replicate
Seek early diagnosis and intervention
Prevention is better than cure. Elite sports programs include early diagnosis and management as one of the key fundamentals. It is certainly much easier to manage most injuries in the early stages when the symptoms are minor than it is at a later stage when the injury is more severe due to lack of early intervention. Stress fractures and tendinopathy (tendinitis) as an example, can be treated quickly and effectively when addressed in the early stages of the injury but can take months when presented late to a sports medical professional.
Work with medical professionals who are invested in your recovery
Professional athletes often have access to medical professionals and other allied staff who are focussed on the rehabilitation and care of the injured athlete. While full time staff and health professionals are a luxury, what is really being offered is attention to detail, careful planning and high quality explanation. These are fundamental to high quality rehabilitation and certainly can be acquired by the recreational athlete.
Be diligent with your rehabilitation
There is no point having surgery or an intervention if you do not have the discipline or motivation to diligently follow the rehabilitation program. The professional athlete will always try to extract maximum benefit from the surgery and the accompanying rehabilitation program. They will approach this like an investment – an investment in themselves and will be both disciplined and motivated to get themselves right and get themselves back into their activity or sport. Similar to professionals, the recreational athlete needs to adopt the same philosophy i.e. treat the surgery and rehabilitation as a package and ensure both are done and completed. Don’t be half hearted – simply put the head down and get it done.
Stay in shape – be prepared to train around your injury
Often when people have an injury they become despondent. They can no longer perform the activity that they love so they go on a hiatus. This is often the worst thing that can be done. As an example, if a runner develops a stress fracture and stops training altogether then after a period of time it’s reasonable to assume they may gain a little weight and due to detraining lose some muscular strength and endurance. When the bone finally heals however they then attempt to get back into running. The problem now though, is that they are heavier, weaker and their protective mechanisms are impaired. They are now predisposed to a whole host of other injuries. The professional athlete, understanding this possibility, will try to cross train and with the assistance of other sport professionals will do those exercises which will maintain muscle strength without compromising the rehabilitation of the initial injury.
Be creative with your training modifications
Just because you are a runner and your injury prevents you from running doesn’t mean that your training has to stop. The same is true for any activity. One of the things that impressed me the most when I started spending time with high level athletes was how creative their rehabilitation plans were. Can’t bend your right knee but like the rowing machine? Only use your left leg. Right arm in a cast? Train your left arm anyway! The training will have a neural crossover and actually increase the strength of the right arm. Recovering from a lower body injury and need to maintain running economy? Run using an Alter G treadmill.
Toughen up when you need to
Some injuries are still safe to participate in regardless of the fact it may still cause you some pain. If you are serious about your competition sometimes you just need to tough it out. Certainly listen to your body but be careful not to confuse the signals coming from your brain. Do not seek out or necessarily adopt the easy option. Use a dose of common sense when you decide to tough it out but remember if everyone stopped doing something because it hurt or it was uncomfortable there would be no marathons completed, no Mount Everest’s climbed and no grand finals played that are recounted years after they were played due to the absolute toughness displayed by those on the field.
What not to replicate
Don’t play with a potentially serious injury
The immense motivation, propensity to healing and higher than normal pain thresholds mean that professionals can and do play with injuries that others could not. When Sam Burgess fractured his cheekbone and continued to play, it was in part lauded as courageous and in part criticised as reckless. It is important to note that there would have been a dedicated player ambulance present in attendance. This is not something that can be replicated playing park football. When Jake Friend (Sydney Roosters NRL player) had a couple of litres of blood drained from his lung and then played two weeks later he had a team doctor on the sideline and another doctor was brought to the game just for Jake. This was in addition to the player ambulance present. Again this is not replicated in many lower level sporting events. While the two previous examples are potentially life threatening it is important for non-life threatening injuries also. Joint injuries usually sound minor but returning too soon when you are young and suffering a more severe injury can potentially derail a career.
Learn when to call it quits
Professional athletes frequently play with chronic injuries and pay for it in later life. This has been a topic of discussion lately especially for the NBA. Derrick Rose has stated he was being cautious with injuries to ensure that he didn’t have sore knees for life after basketball. Charles Barkley responded by saying that was disrespectful and that you shouldn’t mind limping around on arthritic knees when you get to live in a mansion and are paid tens of millions of dollars per year! The average person playing recreational sport though does not have such an opportunity and should adopt the Derrick Rose mind set. Unless you are very heavily rewarded, the glory days of competition will be outweighed by chronic pain and difficulty kicking a ball around with your children. https://www.youtube.com/watch?v=tUhqjjZJcgY
You don’t need a scan for every minor injury
Getting imaging studies like x-rays, ultrasounds, CTs and MRIs sounds like the safe thing to do and the pros seem to do it all the time. Sometimes, though, they can be more harmful than helpful. For many areas of the body imaging studies are less than useful because of false positive and false negative findings. The correlation between findings of spinal scans and pain are notoriously poor. Disc protrusions are present in about 30% of 20 year olds who have no pain or discomfort at all! Disc degeneration is present in nearly 40% of those aged 20 but who are pain free. Early scanning especially of backs has actually been shown to slow recovery. Not because the scan itself does anything to slow the healing process but because of how the information is used. Sometimes this information alone will create fear and morbidity. Elite sportsmen don’t have this problem because they spend long periods of time with staff who can explain these findings in detail. Knee, shoulder, ankle, wrist and hip scans can also be extremely problematic. Many people have cartilage tears that cause no trouble at all. If you have a minor knock and get a scan and you are not careful you may end up with a surgical referral for something that has never caused you any trouble at all. The message is clear seek the best advice and be well informed before you act.
You don’t always need to jump in to surgery
For reasons outlined above surgery is often a more cost and time effective treatment for elite athletes. If you are 4 months out from an Olympics and you rupture your ACL you probably do need to have high risk surgery with quicker recovery like Alysa Camplin did. You probably need it immediately. The surgery she opted for had a much higher risk of complications and failure but was a risk she believed was worth taking. Without it she had no chance at all of competing at the 2006 Olympics and fulfilling life long goals. She went on to win Bronze! The average person though, would be much better off waiting a few weeks for the swelling to settle and having a more traditional surgery with less risk. Sometimes the best thing to do is not to have surgery right away or even consider not having it at all.