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High School Athletes… Injury Prevention Zach Patinkin High School Athlete’s Injury Prevention Ever since I can remember, I have been playing sports. I played a sport each season and excelled in each sport I played, most likely due to a high level of coordination at a young age. Playing hockey and squash in the winter before middle school, soccer and football in the fall, and the best season of all due to the range of such high level sports, spring, in which I played baseball, lacrosse, and tennis.

I knew that I had the most skill in baseball, tennis, and hockey. One day, the day of a little league baseball game, I was sick and been throwing up the night before, my coach told me I did not have to play. The decision was in the hands of the coach because my little league baseball coach was my Dad. When he got to the field and realized he had only eight players, and needed a ninth or else he would forfeit he rushed home and much to my Mother’s dismay brought me to play in the game sick.

Sports have always seemed to come first in my family; I have memories of going to two different sports practices and then taking the next day of school off to rest. My brother was recruited by multiple colleges to play Division III lacrosse, named rookie of the year for his division last year, setting the ultimate family sports goal of excelling in college sports very high. My brother I have been working hard, he in lacrosse and me in baseball, especially to be able to keep playing in college.

My brother played on a high school team that was in a high level division but could not match up to the competition. This allowed him to shine even more because he was forced to make most of the plays for his team happen. He became the school’s most dominant athlete due to these circumstances, which was a highly reputable accomplishment because students go on to play sports in college often from his school. During the college application period, it was a specific group of colleges recruiting him, which narrowed his options but the choice was still in his hands.

He had to weigh the decisions of going to the college of Wooster in Ohio on scholarship, which was not his top choice or go to Babson, which was very close to home and was high on his list but the head coach was leaving that year. It has been my dream since I was little to one day play a sport in college. One of the first times I spoke to my brother after he left for college, he could not tell me enough of how much fun he was having with the lacrosse team. He said the uncomfortable parts of a new school are made so much easier when on a sports team because of the people you meet through the team.

These stories made my goal of playing sports in college so appealing. My parents both grew up skiing with their families when they were younger, and agreed the times were some of their favorite child memories, therefore we always made an effort to go skiing as much as possible every winter. I began with skiing when I first learned but once my brother and sister began snowboarding I gave up skiing and followed their lead. I was skiing last winter, which felt strange because I have been snowboarding since the age of eight.

My friend was using my snowboard and I had on his skis I found out later that this is not the smartest idea. My legs not used to how they are supposed to move to get me down the mountain I flew down the hill with the poles waving awkwardly and each ski moving on its own. After about twenty minutes, I was going too fast when my leg began to slide out and one of my ski tips got stuck in the snow, turning my whole left leg outward at an awkward angle. The pain was immediate, and something about how my knee felt told me everything was not all right.

I let it be known I did not feel well enough to keep skiing the rest of the day and I slowly slid down the side of the hill until I reached the bottom and walked back to where we were staying, walking gingerly on my left leg. I took it easy for the rest of the time I was up in Vermont, only going snowboarding for an hour or so a day. I returned home late Sunday, taking care of my knee as well as I could at the time it was a double dose of Advil and icing. After school on Monday I went to the school trainer, whom after a lengthy examination of my knee, told me the good news that I had no torn ligaments in my knee.

I had strained my MCL, a muscle on the inside part of the knee that allows lateral and horizontal motions (Zumerchik 688-689). She told me if the ski on my left foot had twisted even an inch further, I would have had a season ending injury such as a torn MCL or ACL. It would have been very hard to wrap my mind around the fact that I would not be playing any of my favorite sports for the rest of the year and some of next year. The worst injury I had experienced up until the point of hearing that was a high ankle sprain, which was just over a week of healing time.

Injuring my ankle was the first time I had to leave a sports game due to injury. For some athletes this might not seem very significant, but up until that point I played with the mindset that since I had not been hurt up until that point I could do whatever it took to win and not be injured. After having to see with my own eyes that my body has limits, the way I played sports was altered sub consciously. Our school trainer told me I would be out of my winter sport for around a week, which was a long time for me, but I was just thankful I could still use my knees without needing surgery.

That injury haunts my mind almost every day, the idea that if my leg had been torqued around just an inch further I would still be going to physical therapy and would not be fully involved in organized sports. FeildTurf is one of the most popular types of Astro Turf used by many professional sports teams. It is the Turf used by the New England Patriots, and also the most used field at Moses Brown, which is accounted for as the place the most injuries happen at Moses Brown (Maidment). The most impressive statistic that FieldTurf has to offer on their website is how environmentally friendly the company is.

There is a record kept of how many gallons of water the company has saved by installing their turf fields that do not require a drop of water to thrive. To date the company has saved all their clients 25. 94 billion gallons of water by choosing their product. Where there are more injuries on turf compared to grass fields, especially knee injuries, the vast amount of water, and money for grass maintenance bring positives to having a turf field. (“About Fieldturf©”) Many studies have shown that while turf-sporting fields improve most athletes’ performance, turf can increase their chance at injuring themselves.

One contributor to turf field’s high rate of injuries is the cleats’ athletes wear when playing on turf (Study Finds ACL Injuries More Common on FieldTurf). There are specially designed “turf screws” which are the individual spikes that screw in to cleats. Special turf designed cleats have considerably shorter than most screw in cleat spikes, and the reason is because of the amount of grip needed by the player. On grass it is important for the cleats to dig deep into the dirt so the athlete can get the most push possible.

But since the grip on turf is already very high, the shortening of the spikes on cleats is in an attempt to get less grip. When a player is in a scenario on grass where one foot is firmly in the ground, and the player’s body is quickly moved to another side the dirt can shift and give out so the player’s knee/ankle will not contort. The issue with turf is that once the cleats have sank in to the pellets the only way to remove them is by bringing the foot upwards, not side to side or else it will remain stuck in the ground.

That is the main reason there are so many more torn ligaments in the ankle, and knee on turf fields as compared to grass. (Biomedicine) I noticed very early on when I began playing on turf the increased hold cleats have compared to on grass fields’. When I was new to Moses Brown I used cleats that are designed for grass fields, and I quickly realized I had more push on the turf than I had before on my old school’s grass field. When I asked people at Moses Brown who had been playing on the turf field for years why they didn’t use longer cleats, they told me the risk of injury with cleats that I was using.

A few weeks later I went out to buy new specially designed cleats that were meant for turf, with shorter, but wider screw-in spikes, wider so the cleats still had just as much hold, but less risk of injury because the cleats do not get stuck in the turf as easily. I realized quickly I could move my foot side to side after it was in the ground with turf spikes, as opposed to my grass cleats, which only allowed me to move my foot upwards out of the ground. All these statistics being true, presents a large problem with many athletes’ at Moses Brown.

They either have to have two pairs of cleats, one for their home turf field, and one for the grass practice field, or constantly be switching the types of spikes on the bottom of their cleats. Switching cleat spikes is not the easiest task, taking around ten minutes to swap both cleats, at a time before practice when most already feel rushed to change in time ten extra minutes is not an option. I chose early on in my sporting career at Moses Brown that I would rather sacrifice the increase in grip to put myself at lower risk of being seriously injured.

I use turf designed cleat spikes even when we play games on away grass fields, possibly giving up some much needed speed on the field of play, to make myself safer every day practicing on the turf field. I have experienced very minimal negative effects from my decision to wear turf cleats all season long. I can only remember one time when I have slipped when playing in a game that I attribute to my cleats instead of just a natural fall. This decision has been completely worth it in the long run, because at this point I could have been seriously injured due to my foot getting stuck in our turf one day at our many practices.

When I asked John Hulstyn, a sports orthopedist at Rhode Island Hospital about knee injury prevention, he said, “Stretching is really important to get the knee more used to lateral motions that strain the ligaments. But the problem with that is most high school athletes’ attitude toward stretching. If our coach gave us ten minutes to stretch, we would goof off and talk about anything but basketball for nine minutes, and stretch for one. ” (Hulstyn) Our own Moses Brown football team has to run extra sprints at the end of practices once a week for not taking stretching seriously.

It always surprises me when coaches get angry with teams for talking too much during stretching. I see stretching as accomplishing two goals at once, twenty minutes of team bonding and getting ready for physical activity. Stretching in sports has become very familiar in my life, especially the idea of having captains in the middle of the circle leading stretches. There are multiple people at Moses Brown, Anjuwon Spence, Zack Mann, and both Christian and Andrew Romano, whom have lead me in stretching circles at two schools.

They are all Gordon School graduates, and were sports captains for different sports I played at both schools, giving me a special connection with not only them as people, but especially how they sound when counting. Not only did he tell me what I have to do in the future to try and keep my knees in good physical condition, but also why high school athletes experience so many injuries. Dr. Hulstyn talked about how high school athletes are much more likely to suffer a re-injury in the knee because whereas older people with an injury are likely to remember to wear a brace when playing sports in the future, teens are more likely to forget.

There are two categories of a knee injury. There are two main ways in which one can tear ligaments in the knee during sports direct, and indirect. An indirect ACL tear is the first and less common form of an Anterior Crucial Ligament injury. “This type of injury happens when someone is trying to make a cut, or juke move,” said Dr. Hulstyn, “and pushes their body too hard and the knee ends up giving out from under the person. This is most common in soccer and basketball because of the nature of the sports’ fast moves”.

The form of an ACL tear that occurs most often, are direct knee injuries. “This is when physical contact with another player or object is made to the knee, hyper extending or torquing the knee unnaturally” (Hulstyn). The types of recovery tend to be very different for each type of tear. Patriots super stars; Tom Brady and Wes Welker both tore their ACLs in play a few years ago. Timelines of rehabilitation between Brady and Welker shows that indirect knee injuries are a quicker rehab.

Welker was back performing just as well as he was previously, after just over eight months of rehabilitation (Bowen). Brady did not get back in the game for over a year, and even when he did return his game play was not as high as it was pre-injury. Brady’s biggest challenge was mental. “Learning to get over a move that led to a tragic injury is as big as learning to trust yourself and your own body again. ” This is Hulstyn’s determination of why those like Wes Welker, who tore his ACL when trying to juke a defender, can rehab quicker than those who injure themselves in the other way. Learning to overcome an injury caused by another player takes more than just learning to trust your body more, but getting over the hard obstacle of trusting other players whom you will be playing against” (Hulstyn). As an athlete, I am not always certain of much in the field of play, but I know I can trust my own body to move the way I want it to and that the other team will be trying to stop me from my goal. I do not always have a lot of size to contribute to a sports team, but what I do have is speed.

The main reason I was starting at wide receiver for Moses Brown’s football team was because I was the second fastest player on our team, and having someone who can outrun anyone on the opposing team’s defense is very helpful. I can always trust my legs to carry me faster than the defender trying to make it so that I do not catch the ball. I have never injured any part of my legs to reduce my overall speed, therefore I have no reason to believe my legs would ever do something I did not want them to do, they are a trustworthy working unit within my body.

What I can be so sure of when playing a sport is exactly what was keeping Tom Brady from playing his best. For a long time when he was struggling through surgery and learning how to use his newly re-formed knee, Brady could not trust his body to move and support him like it always had before. What used to seem standard for Brady on the field now made a year of rehabbing flash before his eyes. “A player who previously had not only a cool head in the pocket, but steady feet, quickly become frantic and developed ‘happy feet’ when defenders began diving around his ankles” (Hulstyn).

This shows what can happen to a player’s game after a season ending injury, especially in scenarios that remind the person of the time in which they were hurt. There are many challenges an athlete must overcome after experiencing a multiple season ending knee injury. There is the mental aspect, as stated above with the example of how Brady had to get over the fear of re-injuring himself. But more importantly there is the reconstruction and rehabilitation of the inside of the knee. Orthopedist’s open up the knee, and using muscle grafts from the central patellar tendon and a bone block on the end of the graft.

Several drill holes (usually four) are made at the bottom of the femur bone, and the top of the tibia bone. The muscle grafts are pulled through the holes and placed in the position of the ACL pre-injury. This part of the procedure is done in an effort to allow blood vessels to grow back naturally and healing can occur (Foran). The knee is highly sensitive in the days following the surgery, suggested to stay off one’s feet for two to three days immediately following the surgery. Full weight should not be applied to the injured leg for seven to ten days, calling for a large leg brace known as an immobilizer and crutches.

Professionally supervised physical therapy is undertaken three to four days after surgery. When agreed on by the physical therapist and when is comfortable for the patient they can walk with out the assistance of crutches. It varies for every athlete due to the severity of the tear, but full recovery usually takes around nine months. After the physician has been consulted and clears the patient to partake in contact sports, a knee brace is still required for improved stability (Zumerchik 763-764). There is much more to rehabilitating a torn ACL than merely the surgical fix and months of physical therapy.

There are certain ways of life that a person who has been injured must become accustomed to. “Every day I wake up, and since every time I dream I don’t have a scar on my knee so I wake up thinking my ACL was never injured. I open my eyes, and when I go to fully stretch my legs fully I then feel my left knee not be able to move to its full potential, so I usually spend the first three, or four minutes of my days doing slight knee tweaks and exercises to get my knee feeling loose and easy to walk on. ” (Sharp)

Not only does it change the first moment of every day in someone’s life who has torn their ACL, but certain times during throughout the day that remind that person of how they hurt themselves. When Wes Welker was asked in an interview if he was ready to play, he responded simply, “Yes”; when asked if his knee was as healed as it could be, yet again he responded, “Yes it is”; but when asked later if his knee felt normal, he stated, “Not at all, it does not feel unstable but it feels strange and not the same way it did before I hurt myself. As shown here by Welker, after an ACL surgery everything changes, even after full recovery the knee still never feels completely normal again (Hulstyn. ) “Every day I’m out practicing or playing football I’m wearing a big clunky knee-brace, a constant reminder that your knee was destroyed and you have to build it back up. ” A large part of mental rehabbing after such a serious injury is learning to get over the reminders of the injury that surround you every day. (Bowen) Before I began my research, I had heard women were at higher risk for knee injuries than men. Girls who play sports are three times more likely to tear ligaments in their knee, especially the Anterior Crucial Ligament, than males. And females who play soccer are nine times more likely to suffer a knee injury than boys” (Hulstyn), a shockingly high rate. It is not that woman’s knees are necessarily weaker than men’s, but when running or making cut moves in sports, women’s posture when on the field tends to be more straight up. The more bent the knees are when playing sports; the lower the chance is that a knee injury will occur.

Women play sports at a slower moving pace, and their cuts tend to be at a higher angle. The way men push it to the limit and throw their bodies around on the field of play may result in more “bumps and bruises” types of injuries it actually puts their knees at less of a risk for serious injury (Hulstyn). What makes ACL injuries happen in sports most often is when a player’s foot gets stuck in the ground and the upper part of the leg is twisted in the opposite direction. Because the foot can not move to adjust to where the rest of the body is moving ligaments get ulled in the knee and ankle and if put under too much stress the muscles tear. The goal should be to do anything possible to allow players feet to move out of the ground when the body gets jerked in a different direction, but that is the opposite of what some people’s goals are. Cleat manufacturers sell products that are designed to dig into the field and allow the player’s foot to remain in the ground. This is in an attempt to make athletes faster by pushing off the grip in the ground the cleats provide.

This grip in the ground is exactly why most ACL injuries happen during sporting events. Specially designed cleats are made for turf fields, where the grip is much easier to obtain than on that of a grass field. These cleats provide less hold in the ground and do not keep the foot as anchored into the ground as standard cleats. This is what all designers of cleats must be trying to work into their products in an attempt to avoid so many season ending knee injuries. Coaches should be telling their players that the extra ? nch increase for cleat spikes may provide a better grip on the field, but it is putting them at a higher risk for injury. Those who use turf cleats are making the sacrifice that may make them a tiny bit slower but they are greatly reducing the risk of suffering a knee injury when playing sports. “About FieldTurf. ” FieldTurf. Tarkett Sports. Web. 14 Apr. 2010. This website is the most official turf website I have visited, and is easy to navigate through compared to any other of my sources. The scope of the Website is to those who are in need of turf fields, mainly marketing.

The company website is bias because the use of the website is to sell facilities. The company has been in business for over 16 years, which shows the company is clearly not learning anything for the first time, and have a lot of good experience, yet updates there statistics on the website every few months which makes it quite recent. “Biomedicine; Sports Medicine Physicians Brace for the Injuries of Football Season. ” Obesity, Fitness & Wellness Week. 15 Sep. 2007: 150. eLibrary Science. Web. 15 Nov 2010.

The authority for the medical findings of the teams physician are very well informed, due to the fact that he is the team physician of the professional football team the Buffalo Bills, and professional hockey team the Buffalo Sabres. The lens of the article is through the eyes of the team’s medical staff, and their findings of the most common injuries among the team. Talks about MCL being the most common injury, most likely because their field is grass instead of turf. The article is from three years ago, which still pegs it as a primary current topic, but the players mentioned would most likely not be at the Collegiate level anymore.

The topic that is covered is more broad than most of my sources because it does not just talk about knee injuries, it is more of a general overview of all the teams injuries as a whole, and how often certain injuries occur. Bowen, Matt. “For Welker, ACL Rehab Continues on the Field. ” National Football Post | All Angles. All Access. 10 Nov. 2010. Web. 05 Dec. 2010. <http://www. nationalfootballpost. com/For-Welker-ACL-rehab-continues-on-the-field-4308. html>. This is an NFL official story that was updated multiple times after being posted, which gives it very reputable authority.

The author, being an NFL. com writer gives him a good well-informed lens, so we know he has access to a lot of information. There is very little bias in this article because it is just informing the league on Welker’s current status and does not have any incentive to give people false information. This source is very up to date because it was last edited in November of 2010 so the information is still very relevant in the league. The scope of the article is for those paying attention to the NFL and who want to know not only how Welker is physically but also mentally.

Cluett, Jonathan. “ACL Tears – All About ACL Tears. ” About Orthopedics. 16 Aug. 2009. Web. 24 Oct. 2010. Johnathan Cluett shows a broad understanding of the topic on the Anterior Crucial Ligament, by not only discussing the injury itself, but also the pre-injury, post-injury and rehabilitation. There seems to be a bias shown in this article when referring to the idea of weather or not someone who tears their ACL needs surgery or not. This article was electronically posted under a year ago, which makes it extremely current data.

There is a very broad scope of information in this article; it covers almost all questions one would have of someone who has suffered an ACL injury. Foran, Jared. “ACL Injury: Does It Require Surgery? – Your Orthopedic Connection – AAOS. ” AAOS – Your Orthopedic Connection. Sept. 2009. Web. 24 Oct. 2010. This website article was most helpful because it not only discussed the act of injuring ones knee, but the structure of the knee and ligaments inside. Once one gains knowledge of the make up of the knee, it becomes apparent what kind of motions can cause an ACL injury.

The bias here is the fact that Foran seems to support the surgical option for those who succumb to ACL tears. This article is very current because of its recent revision in the past year. And the scope is very medical; it does stray out to the mental aspect of what happens to an athlete post-operation as well though. Hulstyn, John. Expert interview. 20 Oct. 2010. Hulstyn has been heavily involved in high level sports teams around Providence for over five years. Large involvement in the Brown Bears hockey team, gives him a reputable perspective.

Hulstyn in the interview showed bias when talking about high school sports. Speaking on injuries from the perspective of a high school sports star, which is perfect in this specific ISearch topic. This interview was the day before Hulstyn performed reconstructive surgery on a sports related knee injury, which made the information extremely current. The scope of this interview was guided with the prematurely formulated questions, which kept the interview exactly in the direction it was intended to go. “Protecting Kids From Sports Injury. ” World Book Science Year. 01 Aug. 2009. eLibrary Science.

Web. 15 Nov 2010. The World Book is a very reputable source when it comes to scientific research, such as physical injuries. The lens is through kids who are playing sports; there are cases of injuries that are found early, but if left unchecked could have required surgery, making it very bias against playing on an injury. The source being from last year makes it very current and up-to-date with medical terminology. The article covers very realistic situations; it is somewhat narrow because it never ties in an unlikely freak injury. Sharp, J. D. Personal interview. 5 Oct. 2010.

Sharp went through a traumatic accident while skiing, which resulted in a torn ACL, giving him the perfect perspective to answer questions of the physical and mental aspect of an ACL tear. The interviewee’s POV was that of someone who has not come out of the end of ACL reconstruction, which gives a somewhat negative bias on the subject. The injury occurred last winter, but the feelings of what it put him through are still very much present, which gives it a very fresh current feel. We covered every question I had for the interviewee and then some, making the interview very detailed, and in depth. Study Finds ACL Injuries More Common on FieldTurf. ” ProFootballTalk. 12 Mar. 2010. Web. 15 Nov. 2010. The authority is a professional football (New York Jets) team’s physician, giving it a professional outlook. The POV is written from a team’s medical staff, giving specific facts of how and why turf makes injuries occur more often. This article was posted online earlier this year at the beginning of the football season which makes it very current information. The focus of this article is very precise and goes into extensive detail of the one subject. Zumerchik, John. “Knee. ” Encyclopedia of Sports Science.

Vol. 2. New York: Macmillan, 1997. 668-99. Print. Zumerchik has written over twelve encyclopedias in all, ten of which having to do with sports, two of which are science/history related, showing his is a trustworthy well-known source. The fact that he is such a prestigious sports encyclopedia author, he most likely puts his own opinion on things when writing, just because of his large amount of experience. The scope of his work has gotten more and more pin pointed in each encyclopedia, and when his latest Sports Science encyclopedia came out in 1997, most of the articles are still relevant to sports today.

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