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Commentary Jan 11, 2013

Why the player shouldn’t have final say on risking health

By Jimmy LaRoue

For good reason, has featured a lot of advice about preventing injuries, understanding how our bodies,especially areas such as hamstrings and knees, need to be cared for and tended to prior to an injury, not just after the fact.

But what I don’t see addressed near as much is the sports culture that tells us that we need to play hurt, or injured.

Apparently, for Washington Redskins quarterback Robert Griffin III, there’s a distinction. Already playing with a brace on one of his knees due to a LCL sprain suffered a few weeks before – on the same knee in which he had suffered an ACL injury in 2009 while playing at Baylor – Griffin made an awkward-looking move that clearly showed the quarterback to be in more pain. Witness him taking off his helmet on the sideline and then trying to limp back to the huddle to try to get the next play called.

Griffin wasn’t pulling himself out of the game; he believes he was hurt, not injured. His team’s coaches didn’t call a timeout, presumably so their team doctors, and high-profile consultant Dr. James Andrews, whom the team pays to be there, could take a look at him to determine his fitness for further action.

The talk among Griffin’s peers in the game was of him showing courage and toughness by playing hurt. Instead, who knows how much he set himself back — first of all, by even playing so soon after suffering his LCL sprain, but second, staying in the game after he, along with the team’s coaching and medical staff, knew he had injured himself further.

I bring this example up because this is among the most high profile examples recently of an athlete playing injured and doing further damage as a result. But this is hardly isolated to football.

Griffin clearly is like most athletes who, if given a choice, are going to try and play, thinking he can still make a contribution. The mistake here is that the coaches and medical staff deferred to him on his well-being. But the decision on whether to play hurt or injured should have never been up to him, and it shouldn’t be up to any athlete on a team with a coach and/or a medical staff.

And if it’s a team without an identified coach, such as an over-the-hill league, then the player’s doctor should have to clear the player first.

As Dr. Wendy Lebolt has said on these pages, coaches have to act as first responders when it comes to injuries and have a protocol in place to return to the field. She even talks about athletes who have competed with significant injuries:

The news is ripe with so-called “heroic” stories of athletes who have played through injury. For instance, Tiger Woods competing with a leg break and a torn ACL and 1996 Olympic gymnast Kerri Strugg landing a vault on a severely sprained ankle.  These really should not be our role models and certainly not our standards.  For the kids who have been entrusted to our care and tutelage we need to take the long view. Any compromise in movement means weakness and perhaps subconscious “favoring” by the rest of the body. This significantly increases their risk of injury. Young athletes, though they may beg to get back in there, are not able to see things this way. After all, without a mirror they can’t see themselves move. You have to be this mirror for them.

We’ve heard a lot of talk lately about how to handle concussions in the sport, and she has great advice (Part 1, Part 2) on what to do there as well. I’ve watched at least a few careers end (and there are multitudes). The likes of Alecko Eskandarian, Bryan Namoff, Josh Gros, Taylor Twellman and others have had their careers and lives altered as a result of concussions. We’ve seen youth soccer make national headlines with regard to concussions, and a new federal study has been launched here as well.

But coaches and trainers have to take the decision on whether to play, or go back in a game, out of the players’ hands. Most, whether competing for playing time, a roster spot, a college scholarship or just being afraid of being called out as someone who isn’t tough, will try to play through pain, even if the longer-term consequences are more dire than trying to heal from an initial injury first.

It’s certainly important to get the player’s perspective on any injury, but the final say has to come from a coach or trainer that can override a player who says he or she is “fine” to play (If there is any doubt, the coach should sit a player until he or she has received a medical evaluation and has been cleared to return to action).

Griffin was “fine,” but as we see now, he’s on his second ACL surgery (on the same knee) and an LCL surgery (not to mention the concussion he suffered earlier in the season). And already, the talk is about when he’ll get back on the field and play, not what he has to do to get there, the process it takes, and whether that could have been different had the team’s coaches and medical staff had been looking out for him.

We can only hope that whatever pressures are out there – the pressure to win a roster spot, to win a game, a college scholarship or to avoid accusations of not being tough enough – don’t interfere with a player’s short- and long-term health.

I’d like to think the approach I advocate isn’t being overly cautious rather than pragmatic. We’re seeing more examples of lives being altered as a result of playing through injuries, or because of injuries suffered. I’ve covered soccer for the better part of the last 11 years and seen the good and bad of handling an injured player.

I’d rather see someone live well for the long term, rather than trying to play through an injury, or in spite of one. And that’s why any decision to play after an injury needs to be in the hands of someone other than the athlete.

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