RICE & MICE: To play or not to play?

Throughout the NHL season, there is always pressure for players to play with injury. Sure players can be called “tough” for battling through injury, but is it worth it? 

I’m not going to harp on players that play through injury and say how bad it is, but there are certain innate risks with pushing through injury. Injuries come with the territory of being an athlete.  No matter how fit, no matter how skilled or mentally tough an athlete is, injuries will happen.

The ultimate dilemma is never whether or not an injury will occur; the dilemma usually occurs on the heel of an injury in the form of what to do once an injury occurs.  To play, or not to play: that is the question.

The benefit of playing through an injury must always outweigh the risks involved in making an injury worse or creating a new injury. The old adage of “just suck it up” or “play through the pain” are over, however athletes today are given the choice of whether they want to try to compete with an injury. Continuing to play if you have an injury can make that injury worse. A small stress fracture that might have healed quickly can worsen and grow into a more serious, fracture that may take longer to heal.

Injuries to a weight-bearing joint can cause undue stress on the joint that relies on that particular joint.

For example, an ankle injury, if not properly rehabilitated before return to sport, can alter the way that the knee and hip bear weight, thus making those joints prone to certain injuries. An injury to the right knee can cause over compensation and lead to pain or injury in the left knee or hip. The back also can become susceptible to strain and injury when compensating for an injury elsewhere.

Injuries to the hand, wrist shoulder and elbow don’t typically cause other injuries, but most don’t get better on their own without rest and worsen as time and games pass. Even if surgery is needed and postponed a player likely won’t be fully at 100% while playing. Some players will play nearly an entire season with injuries, however, they never really seem at their best and the teams are so secretive about injury reports, ailments aren’t made public until the season is over. Joe Thornton suffered a separated shoulder in Game 4 of the western conference finals and played a full Game 5 without missing a beat.

After an 82-game NHL regular season, there are bound to be new bruises and sprains here and there. However in the playoffs, we commonly see players push through bruises and sprains, as well as the chronic injuries or pains, such as chronic tendonitis.

Players may experience more soreness and swelling, but they will play through it. The players undergo daily treatments in the training room to both prevent and treat injuries, such as heat, ice, compressions, anti-inflammatory medication, nutrition and hydration. With the physical demands of the playoffs, players may find it difficult to replace fluids lost in the games and some require intravenous fluid replacement between games.

In an ideal world, an athlete also has time to complete all of the necessary rehabilitation and is pain-free before he/she returns to compete. Injuries to professional athletes can have a negative impact on both the short and long term health of the athlete as well as their career and earning potential.  The win-now mentality of professional sports leads to a natural tendency to aggressively treat injuries, by employing surgery for example, where an injury would initially be treated with a period of rest.

A shorter recovery period may get players back in the game as soon as possible. Safe return of an athlete depends on both physical and mental recovery from injury. A player that experiences pain may also be fearful of re-injury. A lack of confidence in the ability to handle the demands of the sport can cause anxiety and frustration causing tentative play and could possibly lead to other injuries.

Pain medication is also a consideration for injured athletes who choose to compete. Instead of treating the underlying condition, treatment is postponed in favor of the athlete continuing to play and contribute to the team. Over the counter and prescription painkillers reduce pain and allow players to compete with chronic injuries; however they may end up with more damage due to the decreased pain when playing.

Painkiller addiction, especially narcotic painkillers, is a very real issue in most professional sports, though it’s not the most common issue to be discussed publicly. If injuries aren’t treated to cure, they are treated to manage pain and unfortunately, the progression is usually to form a dependence on painkillers in order to maintain normal everyday function and potentially larger doses of pain medication for longer periods of time.

In some cases the decision to play through injury may bring the ultimate championship achievement, but it usually is not without a steep price.

Steve Yzerman played the 2001-02 season while battling a knee injury. He won an olympic gold medal with Canada that year as well as the Stanley Cup with the Detroit Red Wings. He missed 2/3 of the following season after having knee surgery to repair the damage done playing on the injured knee. I’m sure if you ask him if it was worth it, there would be no hesitation to his answer.

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