Athletes Push Physical Limits, Conceal Injuries

Since the start of the 2017-2018 school year, Director of Athletic Training Adam Hernandez has seen an increase of 50 injuries on average per week from last year. For some Big Red athletes, the risk of overexertion during daily workouts and overuse injuries developed over a season affects their athletic experience at PEA.

According to Hernandez, injuries peak during the fall season, when trainers receive around 3000 overuse injuries, compared to about 2,000 in the winter and spring. Hernandez said that the fall term’s increased number of injuries is most likely a result of students taking a break from athletics over the summer and arriving to school in weaker physical conditions than when they left. “Generally, if a student begins their season in shape they are less likely to sustain an overuse injury,” Hernandez said.

The boys’ cross country coach, Brandon Newbould, agreed that an injury could come from a lack of summer training, classifying it as an “under-preparedness injury.” “We’re not a fitness club, and kids are expected to come in ready for actual training,” he said. “When they come in unprepared, even if I’m careful they might experience a set-back from taking on too much all at once.”

Rebecca Moore, the junior varsity girls’ crew coach, noted that athletes sometimes push themselves too hard even after sustaining injuries that require rest and recovery. “I know that athletes feel such pressure,” she said. “We work to remind athletes to sleep, hydrate and eat well; in the same way we seek to teach athletes that communication rather than secrecy about injury is the healthy response.”

Moore tries to teach girls on the crew team how to listen to and respect their bodies’ limits. “Some athletes do not always know the difference between healthy pushing and dehydrated, ill-rested, unfed injury-risking exhaustion,” she said. “Just as skill and strength takes practice, health takes practice. We seek to teach all of those elements of sport.”

Director of Athletics Shane LaPointe attributed athletes’ willingness to push through injuries as a result of the misconception that an injury is not genuine unless it is visible. When an injury does not manifest itself in bleeding or other physical signs, many students classify it as insignificant, ignoring it to avoid letting down teammates. “Especially for some people who are particularly hard-working or have very high expectations for themselves, it’s easy to, if they’re feeling something minor, just to pass it off and decide they need to be tough and just keep training,” upper and cross country team member Charlie Neuhaus said. He added that if ignored, minor injuries can worsen. “I think it becomes kind of risky and people have gotten long-term injuries from that.”

Other athletes reported feeling this pressure to play through injuries, whether due to internal goals or external influence from coaches or teammates. A former member of the girl’s crew team recounted running up and down the stadium stairs during an optional crew practice. These practices are held during the off-season, and although not required, the team culture heavily encouraged attendance. Because these practices are held during the off-season, they are led by the captains without the coach’s supervision.

While running up the stadium steps in over 80 degree weather, the player reports she became disoriented from the heat, could not see the step in front of her, tripped and skinned her entire shin. She said that despite her heavy bleeding, her teammates continued to run by her. “I was kind of in the middle of the pack and I fell, but everyone just really wanted to finish that last set and beat the girl in front of them, and no one really stopped,” she said. She added that watching other athletes continue running compelled her to finish as well. After completing the run, the captains told her that she had the option to stop; however, she said, “I felt personally like the team dynamic and the sport as a whole almost forced me to keep going. I think that when you’re on the team and within that culture, these sorts of things are normalized.”

Many students have an understanding that some level of discomfort should be expected from practice, but also that there is a certain threshold of injury above which an athlete should not be allowed to play. “A jammed thumb could be enough to pull a player out of the pool, but we push through petty things such as calf cramps or hamstring strains,” senior and member of the boys’ varsity water polo team Alexi Monovoukas said.

“I think it’s important that they have a relationship with the athletic trainer so that they determine whether that’s something that can be played through or cannot,” Head Football Coach Robert Morris said. “There’s kind of a difference between being hurt and injured.”

The athletic trainers classify whether a player is hurt or injured by determining if they can continue playing. “Ultimately the decision to hold a student out of sport is under the athletic trainer’s jurisdiction,” Hernandez said. He added that the trainers classify injuries by the level of play an athlete can maintain. “We categorize injuries into three primary categories here at PEA: Out, Limited and As Tolerated,” Hernandez said.

If a player is put in the out category, continuing to play would worsen their injury. Athletes are put in the limited category if they are permitted to practice at a lower intensity than usual. Hernandez said, “Most often, a student should participate in some level of physical activity even when injured as this will help an injury to heal quicker.”

Newbould abides by these categorizations and allows someone who is hurt to play, but prohibits an injured player from continuing to practice. “I don’t consider things like cuts, bruises, or blisters an injury, but if a kid can’t handle that I don’t force them to do anything. If they have an injury that requires rest, they rest, and I refuse to compromise on that,” he said.

The threshold of injury is not uniform across teams, and coaches do not always follow the advice of the athletic training staff. If a player throws up during practice, Hernandez usually recommends that they take a break from physical activity. “Generally it is not a good idea for a student to continue to exercise after they have thrown up as it is possible that there may be an underlying issue,” he said. Hernandez added that this problem could range from general sickness to dehydration or a nutritional deficit.

Newbould, on the other hand, does not see vomiting as an absolute threshold for overexertion. He allows players to continue exercising if they have thrown up for a reason other than illness or heat-related exhaustion.“If they throw up because they’re out of shape, pushed harder than they should, or ate three cheeseburgers right before practice, give me a break. Yes, they continue,” he said.

For many athletes, overexerting themselves to the point of exhaustion or nausea is a source of pride, and goes hand in hand with the hard-working competitiveness that many of the most aerobically strenuous sports—cross-country, swimming and crew—require to be successful.

A former member of the girl’s crew team who wishes to remain anonymous said that this competition between players particularly manifests itself when the rowers complete test pieces or trials that determine who makes varsity and junior varsity, as athletes push themselves especially hard to achieve a favorable time. Moore said that this was purposeful, as rowers will improve their skill by working to exhaustion. She said, “Rowing is a middle distance sport that requires pushing the body to fatigue in order to achieve regeneration or ‘second wind.’ Athletes train for this ability.”

Upper Ashleigh Lackey, a member of the swimming and crew teams, has witnessed athletes working to exhaustion or nausea. She said, “I’ve seen athletes nearly pass out at the end of practices.” The unnamed former rower also recalled witnessing players at this level of exhaustion. “Girls would push themselves to limits that I don’t think they should be pushing themselves to and would end up not being able to walk for the rest of the practice or throwing up after they were finished,” she said.

Some Exeter athletes do not think this level of exertion is past their limits, and instead gauge whether or not a practice was successful based on whether they can walk the following day. Monovoukas said about the varsity water polo team, “Our successful workouts are marked by muscles too sore to walk on.”

           Lackey agreed that she used this method to test the effort she put into practices and games. “I try to push myself to the point where I can’t walk anymore. Then I know I truly gave it my all,” she said.

Although some athletes take pride in correlating pain with hard work, others find over-exhaustion or nausea counter-productive to athletic improvement. Upper Gabby Allen, a cross-country runner, said, “I know that I’ve had a good workout if I finish and I am tired but also feel strong and like I got something out of it. If I push myself to the point of throwing up, then it isn’t really productive and will probably only make me miserable and inhibit me from participating the next day.”

Interactions between team-mates and coaches, while providing athletes with support and friendships, also serve to push students to be the best they can be. Monovoukas said about the water polo team, “We always have our teammates’ back but also always make sure to push each other far past our comfort levels in the pool, improving ourselves as a group and always asking for more effort, more intensity.”

He added that the team does not encourage players to push themselves harder than they are able, but rather to work past where they previously expected. “There has never been an instance of a player pushing themselves too far. However, past one’s comfort zone is not at all too far, and we push past that every practice,” Monovoukas said.

Allen agreed that her team members work as hard as they can, but do not do more than they are able to. She said, “I don't necessarily think that people are pressured to push themselves to their breaking point, but they are definitely pushed to try and overcome a lot of pain they might be feeling.”

In addition to the external pressure team-members place on other players, some athletes internally encourage themselves to work up to or past their limits. LaPointe said, “Many of the kids who come here, and many of the coaches who are here are very driven individuals. We like succeeding, we like having goals, we like working towards [them.]”

Other athletes cited pressure from coaches, either real or perceived, as the biggest force driving them to work hard in their sport. The former member of the girl’s crew team recalls the coaches posting test piece results in the boathouse. The results are accompanied by the player’s name and their weight conversion. According to the former rower, the team members would crowd around the list and compare their times with others, speculating that someone’s low weight helped them to reach a favorable conversion. She said, “It just kind of speaks to the culture of the team, and even the culture of Exeter as a whole.” She added that it is similar to if Exeter posted student’s grades or GPAs in the Assembly Hall. “That’s basically what they’re doing, except for sports,” the former rower said.

She added that there was also pressure for players to compete against each other for spots on varsity. The former rower remembers a time when the coach told two athletes that there was only one spot remaining on varsity, and asked each of them to decide who should fill that spot. She said that this, “[Forced] them to either save their own spot and betray their teammate, or give up the spot to their teammate and row JV themselves that weekend.”

The former team member added that, in her opinion, the coaches would not be receptive to feedback a rower might give if practice was too challenging. “I think that the coaches, instead of taking this feedback to heart and making changes in the team, would instead use those criticisms as evidence that the girl isn’t cut out for varsity, and move her down to JV,” she said.

Although coaches can sometimes encourage players to work past their limits, they can be instrumental in improving team dynamics and helping players to allow themselves breaks to recover from injuries. Lackey advocated for coaches and teammates to be empathetic to encourage injured players to take time off to recover. “If someone is in pain, that does not make them weak,” Lackey said.

Allen views the team dynamic as able to influence success, particularly in a sport as strenuous as running. “Running involves a lot of mental strength, both from yourself and your teammates. Even if one person feels upset, it affects the performance of everyone else,” Allen said.

She added that players’ attitudes play a crucial role in making athletics enjoyable. “It’s all about having fun and not taking it too seriously. Of course, it's important to get good exercise in and improve your running, but if nobody is having fun then nobody will want to continue coming to practice, or even keep running at all,” Allen said.

The former rower hypothesized that in addition to students playing sports for enjoyment and athletic challenges, some are incentivized to continue playing by the coaches, who attest they will advocate on a player’s behalf to help them get recruited to college. The promise of college recruitment can also motivate students to specialize in sports and push themselves to new heights.

LaPointe commented that although students tend to overexert themselves in practices and games, due to society’s emphasis on sports specialization, many Exonians arrive at school already possessing this drive. She said, “I think we now live in a culture where kids by the age of 15 are really thinking: ‘What sport am I going to continue playing with?’”

She added that Exeter discourages this philosophy and encourages students to play multiple sports. “We want kids pursuing lifetime activities and getting a breadth of experiences, but it seems that the [message] which is trickling down from the club culture is really, ‘You have got to figure out what sport you have and play for that sport nearly year-round,’” she said.

LaPointe added that this culture of specialization in service of college recruitment is detrimental to players recovering from overuse injuries. She said, “Part of the issue with specialization is what you’re getting out in terms of chronic use.”

LaPointe advocated for rest and recovery as preventative measures students can take to reduce overuse injuries. “Students know at an intellectual level that they need it [rest] for their work in the classroom; but it’s just as important, if not more, for the physical recovery that we’re trying to get students to have on this side of campus,” LaPointe said.

Morris promoted the different approach of increasing conditioning to reduce injuries. “The stronger somebody is, the more somebody spends time on their core, on their flexibility, on their strength and on how they move, those things are the best way to prevent injury,” he said.

However, Morris concurred with LaPointe that students playing one sport year-round face greater risks of chronic injuries. “A lot of times you see overuse injuries in sports where kids are specializing, and they’re doing that same activity all the time,” Morris said.

The National Federation of High School Associations disclosed that high school athletes who specialize in one sport are at a 70 percent greater risk of suffering from injuries than students who participate in multiple sports, as they continually place more stress on one group of muscles than athletes who cross-train.

In addition to likely leading to a greater number of injuries, athletic specialization has decreased football’s popularity, as many parents have chosen to focus their children on a sport they perceive as safer. The Northfield Mount Hermon School (NMH) has ended its football program due to a lack of interest, and both the Ivy League schools and the National Football League (N.F.L.) have imposed new regulations to protect players from concussions. In 2012, the N.F.L. limited coaches to 14 full-contact practices during the 18-week season, and the Ivy League coaches unanimously decided to eliminate all full-contact practices, instead opting to utilize tackling dummies to protect athletes from brain trauma.

At Exeter as well, students are choosing to play multiple sports instead of solely football. “It’s not one that kids tend to specialize in, so nearly every kid on that team is playing something else,” Morris said. He added that Exeter is working to provide football players with the safest possible experience. According to Morris, proper blocking and tackling technique, good equipment and strength are the most effective ways to prevent head injuries. “We feel like we teach the best and most modern techniques for blocking and tackling, and that’s probably the best way to prevent concussions, knowing that there’s not really anything that’s going to 100% prevent concussions,” Morris said.

Morris added that he is using education to ensure football players know to seek help for a possible head injury. “The education is making sure that they understand the seriousness of having a head injury, that it’s not something to just shake off and disregard. That’s the biggest piece, is that this is real, it’s important, it’s serious and not something to be downplayed.” According to Morris, if a student has been hit in the head, they are immediately taken from practice and sent to the trainers, who have a protocol to identify and treat concussions.

The NFL has recently faced issues with retired athletes committing suicide and later being found to have severe chronic traumatic encephalopathy (CTE), a degenerative brain disease which has been tied to repetitive mild head trauma. While the conventional wisdom previously held that CTE was caused by major head trauma, recent studies have shown that players can develop the disease without ever experiencing a severe concussion.

Upper Will Stokes noted that he frequently experiences head pain during the season. “After games your head always hurts,” Stokes said. A member of the football team who wishes to remain anonymous added that unless a coach required him to seek help from the trainers, he would continue with the practice or game he was participating in. He said, “You don’t go to the trainers for a concussion unless you black out.”