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With the start of the pro football season and the new academic year, where fall sports programs are underway at colleges and high schools nationwide, sports-related injuries are occurring, both on the field during competition and during practice sessions. Concurrent with this, rehabilitation-related therapies are administered by certified athletic trainers and physical therapists to help these athletes recover from their injuries.

While many of these therapies have been in existence for a long time and other, newer ones have been developed, an alarming number of these injured athletes do not appear to be complying with the rehab programs that are designed to help them. This was the conclusion drawn by a research team in a recent study that was published in the Journal of Sport Rehabilitation.

According to the study, “Rehabilitation adherence is accepted as a critical component for attaining optimal outcomes. Poor adherence is recognized as a problem in the athletic training setting.” The study produced some alarming numbers over a fifteen-year period between the 1988-89 and the 2003-04 college athletic seasons. Out of an estimated 380,000 student athletes participating in 15 of 23 National Collegiate Athletic Association (NCAA) sports at more than 1,000 institutions nationwide, 72,316 injuries were reported during games. This translates to an average of 13.79 injuries per 1,000 athlete exposures. An additional 109,160 were reported during practice sessions, translating to an average of 3.98 injuries per 1,000 athlete exposures. And these are just the reported cases. There is reason to believe that actual injury rates could be higher.

To cite just a few more numbers, the study found that “sport-injury rehabilitation-adherence rates in community-based sports medicine rehabilitation settings (e.g. physical therapy or physiotherapy clinics range from 40% to 91%. In one study, physiotherapists reported that 55% of patients were not fully adherent with prescribed home modalities and 51% of these patients were not fully adherent with prescribed rest from activity.” The study went on to assert that less than 100% adherence “may be less than optimal.”

The study did not break down by numbers or percentages which sports the reported injuries occurred in. For the overall purpose of the study, this was probably intentional, but it’s safe to assume that a large percentage of those injuries may have been incurred in the contact sport of football, and this is going to be my focus here.

Having worked with hundreds of professional football players over a period of thirty years, I have encountered many diverse patterns of injuries and have helped in the management of these players through the rehabilitative process before they go back out on the field. Injuries are an intrinsic part of the game of football; they go with the territory. Football players know this going in, and they usually prepare themselves for this on the physical level with high-intensity functional workout regimens. What they are NOT often prepared for is the EMOTIONAL impact an injury and the “sitting-out” process will have on them. I will comment on this a little further on. For the moment, however, I want to focus on injuries and rehab adherence.

I don’t like to use the term “damaged goods” but, when talking about many of the pro football players who come to me during or even after their pro careers, where there is an injury involved this is often what I’m dealing with. The injuries they sustain during their pro careers may often date back to their high school or college playing days. The training they endure during practice sessions can be as much a cause of the injury as the impact sustained during a game, if that training is not done correctly.

For ten years prior to Katrina I administered my NFL Draft Preparation Program, which helped prepare players for the yearly February NFL Combine and for their “Pro Day” on their respective college campuses. During this time I was amazed to observe how many previously injured players were in that number. This is why, after extensive evaluations, I chose to work with only about ten players at a time. But, even today, I am flabbergasted at the ability of some of these athletes to play with such collateral damage.

Serious hamstring pulls are one of the most frequent and debilitating types of injuries I encounter, followed by groin injuries. Research appears to show that a hamstring injury, after healing, has a 50% chance of re-injury. My belief is that, especially in the pros, injuries like hamstrings are not being effectively managed and players are being brought back too quickly, either by their own choice or by permission of the team.

Depending on the seriousness of the injury, such as an ACL (anterior cruciate ligament), a player may be sidelined for an entire season.

Last year, during the football season, I teamed up with an orthopedic surgeon on a series for the Washington Post‘s online NFL site, “The League.” For 17 weeks we discussed injuries and the effects they were having on teams. The loss of a key player, especially a quarterback, can have a major impact on an entire team and can change the dynamic of its season week-by-week. It can range from being a “game changer” to a “season changer” for a player and his team. As training methods adapt to the nature of today’s game and collisions occur at greater speeds, we will continue to see devastating injuries. And, as these injuries occur, there will always be someone to come in and take the place of the player who has been carted off the field. No matter how important that injured player is, there will always be someone to replace him on the field. The game must go on in spite of the injuries that occur to key players.

Statistics I have seen from the website FootballOutsiders.com point to the fact that, at any given point during the course of a pro season, anywhere from 2.1 to 2.4 active players are sitting on the bench with injuries, whereas that number drops to 1.4 to 1.7 during the playoffs. What this tells me is that a lot more players are playing injured when there is more at stake, as is the case when a team makes it into the playoff rounds.

So, the bottom line here is that effective injury management, prehabilitation (injury prevention) and functional performance training, all of which I successfully manage for the client, are the keys to long-term success at all levels of play – high school, college and the pros. And, concurrent with this – as I alluded to earlier – is the emotional aspect a player must face when an injury takes him out of the game. In my experience this is the most devastating thing to a player because they are nearly always unprepared for the psychological impact of an injury. This is something they definitely have to think about and prep themselves for, along with the physical side.

When you only have the ball for four plays in an entire half, it is hard to score. West Jefferson had that distinction Friday night against Helen Cox but managed a score. It proved to be important.

After falling behind 13-0, West Jefferson rallied in the second half to edge Helen Cox 20-19 in a thriller in the second game of the West Bank Optimist Jamboree at Hoss Memstas Stadium.

When you only have the ball for four plays in an entire half, it is hard to score. West Jefferson had that distinction Friday night against Helen Cox but managed a score. It proved to be important.

After falling behind 13-0, West Jefferson rallied in the second half to edge Helen Cox 20-19 in a thriller in the second game of the West Bank Optimist Jamboree at Hoss Memstas Stadium.

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