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Unbreakable

MAXIMUM FITNESS – You’re not Dwayne Wade or Lance Armstrong, and neither are we. But when our bodies break down, you Dwayne, Lance and I are bandaged brothers, with the same roster of breaks and bruises that account for 80 percent of all sports injuries.

WEIGHTLIFTING > Acute Cuff Tear
Metrosexuals aren’t the only guys who monopolize the mirror. Guys in the gym spend a whole lot of time gazing at their biceps, pecs and quads—the anterior muscles often referred to as mirror muscles. But what you don’t see can hurt you, especially at the shoulder. “You get relative overdevelopment of the front of the shoulder at the expense of the rear deltoid and, more importantly, rotator cuff muscles, which can easily be strained,” says Nicholas DiNubile, MD, orthopedic physician for the Philadelphia 76ers and author of the book Framework: Your 7-Step Program for Healthy Muscles, Bones and Joints.

Balancing your workout is the obvious solution. Pair your push and press exercises with pull and row exercises, DiNubile advises. “Make sure to include rotator cuff exercises [such as incline fly’s, above, side raises and bow-and-arrow exercises with elastic tubing] into your routine,” he says, or risk stiff shoulders, lack of strength, pain when reaching overhead, shoulder dislocation or an excruciating rotator cuff tear. If you’re already hurting, DiNubile recommends RICE (see page 90), anti-inflammatories (aspirin or ibuprofen) and a hiatus from working the injured body part. If the pain is intense and persistent, see your doctor and get ready for a lecture. And then do a better job of training your opposing muscles when you get back to the iron.

FOOTBALL > Burners and Stingers
By nature, football is a physically punishing sport—which is why we love it so much. “But proper technique can lower some of the risk,” says Eric McCarty, MD, chief of sports medicine and team physician for the University of Colorado and University of Denver. One glaring problem is defenders dropping their heads before a hit. “This puts a lot of force on their cervical spine,” says McCarty. “It can cause fractures—and in the worse case, paralysis. It can also allow the ball carrier to juke you or stiff-arm your head into the field.” Symptoms of a bad hit, beside grass-stained teeth, include pain radiating from the back of the neck and down through the arm, tinging and even loss of strength. McCarty recommends an immediate application of RICE to the back of the neck and getting checked out by a doctor. In man cases, it may be a burner or stinger, which occurs when the bundle of brachial plexus nerves in the neck and shoulders is stretched or pinched. The result is a sudden burning and/or stinging pain, hence the nickname. McCarty says the best way to avoid problems is to just keep your head up when tackling so your spine has a more natural curvature. Use your shoulder, he also advises, but don’t reach out when tackling. That can get your shoulder dislocated.

GOLF > Golfer’s Elbow
Lewis Yocum, MD, is an orthopedic surgeon who works with the Anaheim Angels and the PGA, and he’s seen it all. Throughout the week he treats pros from various sports, but Monday mornings are generally full of golfing weekend warriors complaining of lower back, shoulder and elbow pain. Warming up could have saved them the grief, particularly for differs already prone to overswinging: doing a rubber-man windup and then powering through the b all with all your strength. If that’s you and you’re lucky, you may gain some distance. What’s more likely is slicing your $5 Maxfli Blackmax into the trees. And while you’re running up your score, you can hyperextend muscles and ligaments in your arms, elbow and back, since golf torques the body like no other sport.

Lousy form can, among other things, lead to medial epicondylitis, a.k.a. golfer’s elbow, which comes about when the shock of hitting the ball travels from your club’s sweet spot up through your hands, arms and joints. Sharp inner elbow pain and wrist weakness will be a few ways your elbow will remind you that your swing truly sucks. Yocum encourages lessons to correct mechanics, and urges golfers to always use tees at the range. And let the clubs do the work. You’ll get more days on the links that way.

We spoke with Bill Hartman, PT, CSCS, a therapist in Indianapolis, Indiana, who specializes in golf fitness, for exercise to help counteract golf’s specific stresses. See Golf Twist and Golf Punch, opposite.

ROWING > Prolapsed Disk
Rowing is a combination of techniques and strength, according to Jo Hannafin, MD. It’s important to have good technique and a strong core in order to avoid injury.

Hannafin should know: she’s a three-time gold medalist at the U.S. National Rowing Championships, and an orthopedic physician for the U.S. Olympic rowing team. The most common injury she sees occurs in the lower back—the point where power is transferred from the legs to the torso and arms. Fatigued or inexperienced rowers will droop forward and overwork these back muscles instead of swinging through their hips. The result is what rowers call “shooting your tail.”

Your butt shoots out and you get a lot of flexion in your back,” says Hannafin. “These are the areas where you have the highest concentration of forces during the rowing stroke.” Focusing on perfect form is your best solution: you should be upright and leaning slightly forward, so the weight is placed on your feet instead of your seat. The alternative? “Pain will shoot across your back muscles. You’re not going to be very fast either.” And in the worst cases, there’s agony: if you experience a deep sciatic pain that radiates into your butt and legs, you should see a doctor right away. You may have a disk injury—that is, your disks are bulging or have burst.

For rowers, Craig Ballantyne, MS, CSCS, recommends back and core strengthening exercises such as the plank, to help you withstand the sport’s demands.

SOCCER > Metatarsal Fracture
A player races up the field with the b all, snaking through the opposition like a skier on a slalom course. From one side comes a defender, sliding in to tackle the b all away, but he misjudges and hits his opponent’s shoe instead. Someone call a medic. Rob Palumbo, MD, is an orthopedic surgeon for the NFL Players Association and the U.S. Women’s National Soccer team. He says tackling is one of the most dangerous parts of soccer. When the toes are outstretched, the metatarsals (any of the five long bones between the toes and ankle) can be severely sprained or fractured. You’ll know it by the pain, swelling and difficulty getting b ack up, and you’ll need a trip to the hospital, since the fractures are not the kind of injury you can shake off. Palumbo says the best way to prevent injury—and a red card—is proper positioning and timing. If you’re too close, you can take out somebody’s knee. If you’re too far and stretched out, you can get stomped (that’s what happened to Manchester United superstar and Spice-husband David Beckham). Always keep your eye on the ball, stay low and don’t make the tackle when the b all is at the dribbler’s feet. Wait for it to be kicked ahead a few feet and then angle in. Whatever you do, don’t waver. Fully commit to it and kick through the ball.

VOLLEYBALL > Ankle Sprain
William Briner, MD, says volleyball is truly a team sport since the most common injury, an ankle sprain, often involves a blocker and a spiker. The two players leap heroically into the air to make the play, but the spiker’s momentum carries him under the net. Spiker lands, blocker lands on top. It sounds painful for the trod-upon spiker but it’s the blocker who gets hurt, says Briner, who serves as a team physician for the U.S. national volleyball team. Unfortunately sprains are often inevitable in volleyball, he says. The foot will roll, which stretches or tears the outside lateral collateral ligaments (LCL) in the ankle. Pain, swelling and tenderness are a few symptoms that can be treated with RICE. Anything worse merits a trip to the doctor, Briner says. He also advises patients to wear a brace for as long as a year after the injury, since your first sprain greatly increases the likelihood of a second.

BASKETBALL > Jumper’s Knee
One of the most important skills an athlete can lean in basketball is how to make a soft landing. It sounds deceptively simple, but DiNubile is amazed by how many players don’t know how to accordion their knees. Stiff-kneed landings can lead to infrapatellar tendinitis or jumper’s knee, a painful overuse injury that occurs when the tendon that connects the patella (kneecap) to the tibia (shinbone) becomes inflamed. To avoid it, DiNubile recommends practicing making solid square landings and absorbing the force by bending your knees. He also recommends doing quad and thigh stretches to build up leg strength and flexibility. (Ballantyne also recommends strengthening exercises such as the reverse lunge). If you do eventually experience tenderness, swelling and difficulty bending or straightening the leg, don’t ignore it. If jumper’s knee is left untreated, it can become chronic and possibly require surgery.

RUNNING > Shin Splints
You’re on your tenth lap and you feel like you have 10 more in you and another 10 after that. That’s all great except your endorphin high is probably masking what those extra heel strikes are doing to your legs and joints. Overtraining is one of the biggest mistakes Palumbo sees. He’s treated more than a few patients who have precipitously doubled their mileage to train for a race. And though you may have the wind for it, your body suffers because it hasn’t had a chance to acclimate to the extra stress. The result is shin splints, an inflammation of the muscles around the inside edge of your shin bones that comes with a burning pain up and down your lower leg.

It’s tempting to ignore since the pain comes and goes, but shin splints can be a symptom of a more serious injury, such as stress fractures—tiny hairline cracks in your tibia. Palumbo recommends an ice massage for shin splints. Rub a block of ice up and down on the inside of the calf for approximately 10 minutes to help reduce the inflammation. He also recommends runners stop for a day or two to see if the pain continues. Recovery can take up to two months, or more if you have stress fractures. Whether you do, don’t ignore it since running on stress fractures can lead to permanent injury. Palumbo also recommends runners follow a sensible schedule tailored to their goals that allows the body to recover between sessions. Increasing distance by 10 percent per week is generally a good baseline.

TENNIS > Tennis Leg
Tennis elbow is the poster child of overuse injuries. But another ailment that’s just as common among players age 30 and up is tennis leg, or a medial gastroc tear. Tennis leg occurs when the upper calf muscle at the inner side of the leg is stretched and torn. It happens so suddenly that athletes often think they’ve been hit in the b ack of the leg by a ball from the next court. A bruise and swelling can form on the calf, followed by debilitating pain that makes walking difficult. DiNubile says tennis leg is the result of failure to warm up and stretch, and of not being properly hydrated—muscles are 72 percent water, and they don’t function well when they’re thirsty. The tipping point can often be a change of shoes—even a slightly lower heel height or a stiffer sole, for example, may force your calf to flex differently than your body is used to, resulting in undue strain on the calf or Achilles tendon. So you might want to spend some quiet time in your new sneaks before debuting them on the court. Fortunately, medial gastroc tears don’t require surgery like Achilles injuries. He recommends a few weeks of rehabilitation and then easing back into the sport, since many athletes re-injure the muscle by doing too much, too fast, too soon.

SKIING > ACL Tear
You’re going down a double black diamond and come off a bump going backwards. You contract your quads hard to pull your shins forward and hear a pop. All of a sudden your knee gives out. Congratulations. You’ve probably torn your ACL, says Jeff Malumed, MD, a physician for the U.S. Olympic downhill ski team. One of the most common injuries he still sees in skiing is the anterior cruciate ligament (ACL) tear. Although new ski technology has reduced the number of knee injuries, it’s not perfect, which is why experts stress the importance of having properly fitted equipment that’s tuned to your performance level. For the rest of us mortals who simply fall funny and tear the ACL due to bad technique, Malumed says it’s important to learn to re-center our weight when coming out of turns and off of moguls, especially when linking turns. Keep your hands in front of you and use pole plants to establish a rhythm. Don’t let yourself fall back too far onto your heels or “into the back seat” since that can cause you to lose control and wipe out in a way that torques your knees. If your ACL goes on you, you’ll feel a pop, a loss of stability and swelling. You might even feel bones slide against each other, says Malumed. This is not something you can treat at home. Get yourself an orthopedic assessment as soon as you can, since serious ACL injuries don’t heal.