Scribe discovers that injured athletes don’t like to change sports

Gina Kolata

Gina Kolata of The New York Times, a bicyclist and runner, got injured recently. When her doctor told her to cool her exercise jets for a long spell, she rebelled. As do we all. She wrote about this process yesterday. Read it here. I love this passage: “There are several reasons some people find it hard to switch sports, he told me. Often, their friends do that sport, too; it is how these people identify themselves, part of their social life. And then there is another, more elusive factor. ‘There is something about the experience — be it figure skating or running or cycling — that really produces a pleasurable experience,’ Dr. Coppel said. ‘That connection is probably not only at a psychological level but probably also something physiological that potentially makes it harder for these people to transition to other sports.’ ”

My theory: Our taste in sports is like our preference for music — fossilized in the formative years of ages 16-24. Once a Beatles fan, always a Beatles fan. Likewise, track is my game. Same for you?

Here’s the story in case the link goes south:

‘When Dr. Michael Joyner, an exercise researcher at the Mayo Clinic, heard I’d gotten a second stress fracture, high on my fibula, less than two years after recovering from my first one, in a metatarsal bone in my foot, he sent me some advice by e-mail.
Well

“I would urge you to take a year off of running,” he wrote. “Stop trying to rope-a-dope this. Cycle and do the elliptical and take some swimming lessons.” He added, “I did — took 10 years off of running and my perspective is different.”

Right. He’s got to be kidding. I am one of those people who seem to lurch from injury to injury but keep coming back to my sport. I also am a serious cyclist, but running is my true love.

I’m not alone. Margaret Martonosi, one of my running friends and an electrical engineering professor at Princeton University, is a runner and a competitive swimmer. Last year, she injured her Achilles’ tendon. She took a month off and finally saw a doctor, who told her that her running days were over and that at age 45, she really shouldn’t be running anyway.

That was “a bit incongruous,” Margaret told me, because she had just had her best times ever in the New York marathon and in a half marathon she ran while training for it.

She changed doctors.

What is the difference between Mike Joyner and athletes like Margaret or me? Or between us and the legions of others in the Joyner camp — people like Dr. Michael Weiner, an Alzheimer’s researcher who told me he used to run marathons but took up swimming when his back kept bothering him. Now he belongs to the Dolphin Club in San Francisco. He swims with them every morning at 5 a.m. in the San Francisco Bay — without a wet suit — and never looks back. Or Dr. Jason Karlawish, an associate professor of medicine and medical ethics at the University of Pennsylvania. He reluctantly abandoned running after he tore his meniscus, a crucial piece of cartilage in the knee.

“I was frankly demoralized that I’d be one of those people who ‘used to run’ and athletics would slowly become part of my past,” Jason said. It took time and effort to learn a new sport, he added. But now he loves swimming, especially, he says, the meditative aspect. “For 45 minutes, I can see little, hear only my thoughts, and talk to no one.”.

At least one expert, recommended by the American College of Sports Medicine for this column, would say we stubborn athletes have a psychological problem.

Our behavior, said the expert, Dr. Jon L. Schriner, an osteopath at the Michigan Center for Athletic Medicine, is “compulsive”: we let our egos get in the way, persisting beyond all reason.

But another expert recommended by the college, David B. Coppel, a clinical and sports psychologist at the University of Washington, has another perspective. There are several reasons some people find it hard to switch sports, he told me. Often, their friends do that sport, too; it is how these people identify themselves, part of their social life. And then there is another, more elusive factor.

“There is something about the experience — be it figure skating or running or cycling — that really produces a pleasurable experience,” Dr. Coppel said. “That connection is probably not only at a psychological level but probably also something physiological that potentially makes it harder for these people to transition to other sports.”

Jennifer Davis, a physical chemist who is my cycling, running and weight-lifting partner, adds another reason. Often we stubborn athletes — and Jen, an ultra runner who competes in races longer than marathons, includes herself in that group — have found that we do well, get trophies, win at least our age group in races. That makes it hard to stop.

My doctor, Joseph H. Feinberg at the Hospital for Special Surgery in Manhattan, says it’s not always necessary to give up a sport because of injuries.

“Some will say you need to stop,” he said. “But often correcting faulty mechanics, the right exercises or rehab, or just changes in training techniques are all that is needed.”

He knows what it’s like to have a passion for a sport. Dr. Feinberg, a runner, swimmer and cyclist, has had two stress fractures yet keeps running.

Meanwhile, Margaret Martonosi says her tendon has improved enough that she can run two miles five days a week. It’s not much, she said, but “I’ll take it.”

I too am starting to run again. I also did so much rigorous bicycling when I could not run that I am considering entering my first bike race, a 35-kilometer time trial, which means you ride as fast as you can for 21 miles. But running is still my passion.

And Mike Joyner? He went from running to swimming and is now doing triathlons. And he’s glad.

“Whenever I have switched sports it has been energizing because it is a new set of experiences and challenges,” he said. “There are new opportunities to P.R.” (The initials stand for personal record, the best time you’ve ever had.)

“Now that I am doing more running again it feels fresh, too,” he said, “and by essentially skipping 10 years, I did not have to deal with the existential death spiral associated with progressively slower times. I came back with a blank slate.”

Margaret understands that — her swimming times had leveled off, but with running, she says, “I feel in ways like I just started, and that I have a lot more to get out of the sport.” She says there might be a day when she gives up running, but she is not there yet.

But Mike will never convince people like Jen and me.

“I could give up cycling,” Jen said. “But I could never give up running.”

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August 18, 2010

21 Responses

  1. Rob D'Avellar - August 18, 2010

    Like many health problems, many sports-related injuries have more than one cure. Medical professionals who say “stop the sport” as the cure for a sports-related injury usually aren’t listening to the patient-athlete, especially when the patient is older.

    “Stop the sport” is the easy way out…for the doctor. He doesn’t have to be creative in his treatment of older athlete.

    When a doctor says “stop the sport”, what is he really saying is “you’re old…you shouldn’t be doing this in the first place.”

    Would a doctor tell a young dancer, for example, to stop dancing because of a dance-related injury? Probably not. He would devise a course of treatment to return the dancer to the dance.

    Medical professionals need to think of creative solutions when treating older athletes and realize that saying “stop the sport” is ageism, pure and simple.

  2. Jerry Smartt - August 18, 2010

    Okay, gang, here we go again with the ‘pain here-pain there’ thing. As a runner, I never thought that I’d have painful shoulders. Hellooo! I mean, I’ve never thrown a javelin. In my case, I LOOK like a javelin, but I digress. I’m trying something I’ve never tried in 73 years of running. It has a different name in the Orient. I’ve renamed it EEEOWCUPUNCTURE. 1st session I had six needles in each arm. Imagine a piece of string cheese pin cushion. Just yesterday, I had a cataract removed. Before the op the nurse explained everything and said, “Any questions?” I asked her if doc would have a slug of whiskey ready for me afterwards. I was second in line for the two-minute operation. I heard the nurse do her routine: Diabetes? Yes. High blood pressure? Yes. Pacemaker? Yes. Neuropathy? Yes. I thought, damn, here I am, after 79 years with sore shoulders. Is this sport great or what? I tell people that I have 25 years to go, for sure, and they’re thinkin’, this cat’s smokin’ more than lettuce. We’re blessed, kids. Never stop moving. Smartty

  3. John - August 18, 2010

    Most doctors know very little about health and fitness. They spend their careers around sick people, so they become experts in pathology

  4. Roger Pierce - August 18, 2010

    I will be 66 years old in less than two months.I came back to sprinting at age 39, and had some decent results, enough to become hooked not only on the competitions, but the actual training.It was an incredible opportunity to remain fit and feel good about my physical conditioning.
    When I was 43 years old and doing fairly well on the track, I visited a “knowledgeable doctor”, for help and advice in order to overcome a few nagging injuries. I was astonished at what he told me! He advised me to completely stop sprinting because the human body was not meant to stress itself in that manner after 40 years of age!!!!Not for a moment was I convinced he was right, and I proceeded to find ways to heal myself through research and networking with other Masters sprinters, and medical professionals.
    That was twenty three years ago. Since then I have accumulated 10 World Records, won 11 World Championships and many US National records and Championship titles..and was also elected into the USATF Masters Hall of Fame.And all these accomplishments are interwoven with friendships gained through training and competition with incredible individuals, male and female, from all over the world.
    I almost never had enough money to compete in many of the World and National competitions, but I attended whenever it was possible through the kindness of so many friends and supporters, and I am forever grateful for their help.
    None of that would have happened if I had deferred to the doctor 23 years ago.
    This is a quality of life issue for all of us engaged in whatever activity we choose. It is not about trying to be 18 years old again but rather never giving up and always pushing the envelope in our training and daily activities.One can never know what the results will be, but we can initiate a pattern which will perhaps give us a bit of luck….Luck being the confluence of opportunity with preparation.
    Never, Never, never say die….just try.

  5. Steven Sashen - August 18, 2010

    I don’t think your choice of sport is a matter of taste or preference or early imprinting. I think it’s about finding a match for your body/mind.

    I started as a diver and then transitioned to gymnastics (very similar sports) because I enjoyed jumping, rolling, flipping (I became an All-America gymnast). I was also a sprinter from an early age… not because of preference but because I was fast, but only for a short distance. I took to pole vaulting because it’s a combo of the two, above (but had to give it up once I discovered a broken L5).

    Distance events have never interested me. The marathon? Hell, I don’t like doing things I *enjoy* for 3-4 hours. Team sports? Doesn’t match with my desire to be responsible for outcomes.

    None of these are mere preferences, but are mismatches for the way my mind works or my body likes to move.

    In fact, I had a horrific 15 year period after blowing out my knee and being unable to tumble. I tried maybe 10 other sports, looking for something that “fit.” No luck. I even found things I was good at but that weren’t, ultimately, fun (or fun enough).

    I’m forever grateful to my friend who told me about Masters T&F which got me back into sprinting after a 32 year break.

    One day, while hobbling around the house with a pulled hamstring, my wife asked me, quite genuinely, “Are you having fun?” “More than I could possible describe,” I answered.

  6. Rick - August 18, 2010

    In my experience, most Medical Doctors’ experience is not with aging patients that that still compete in sports. Their advice to quit running or change sports is probably statistically correct, based on their entire population of aging patients. A recommendation to stop what you are doing or change sports does not properly address the “mental health” of the patient.

  7. peter taylor - August 18, 2010

    Well said, Roger Pierce. I have worked with many physicians over the last three decades, and I have great admiration for them, but these ideas of working out quite hard, exercising into one’s 90s (or beyond), entering athletic competitions, etc. just don’t seem to fit well with the orientation of a lot of physicians.

    Let’s see….internal medicine, surgery, obstetrics and gynecology, pediatrics, diagnostic imaging (formerly radiology), pathology … where does fitness come in? Much better to start with an unusual finding, say something strange on a CT scan, then more tests, a diagnosis, then treatment. Now that’s “being a doctor.”

    Perhaps “this other stuff,” like swimming, cycling, running, and so forth seems too amorphous, too “unscientific,” too disconnected to the world of disease to be of real interest to physicians.

    One area where there may have been a distinct improvement among physicians is awareness of the value of a high level of fitness for people who enter the health care system. One of your sprinting friends, Roger, now in the 65-69 group, recently confided to me that a study for something completely unrelated revealed something suspicious about one of his kidneys. Turns out it was kidney cancer. Soon after, another study revealed he had colon cancer.

    I bring this up because one of the physicians involved gave credit to this sprinter’s high level of fitness. This, I would guess, would be important in at least 3 areas: (1) Ability to tolerate surgical procedures or even be considered a candidate for such procedures.

    (2) Ability to recover from the procedures and return to normal without being compromised by poor pulmonary function, circulatory problems, or a variety of other issues that are so common in the unconditioned man or woman. (3) Ability to return to one’s status before the whole medical regimen (in this case for the two cancers) began.

    Your friend seems to be doing quite well and actually ran the 100 in a recent meet (with a much slower time than his previous level, of course.)

  8. buzooti - August 18, 2010

    Thank you Roger and Peter,

    Your words are much needed encouragement.

    As someone recovering from and rehabbing a recently repaired ruptured achilles, I am getting many strange reactions to how I was injured in the first place. It’s as if rupturing your achilles getting off the couch is somehow more acceptable. To my dismay, much of this has come from healthcare professionals from physical therapists to doctors specializing in sports medicine.

    Thankfully my surgeon understands my desire to recover fully and return to the track. Hence, she has designed a conservative, thoughtful plan to do so.

    I’ve aged in awe of the likes of Payton Jordan, Marty Krulee and the humble Mr. Thigpen–so it will be sometime before I simply do “something else”.

  9. Karl Hawke - August 18, 2010

    Unfortunately, we Masters Athletes don’t fit neatly into the diagnostic paradigms into which most doctors try to shoehorn patients.

    The “typical” patient ranges from obese to sedentary to moderately active. Rather than encouraging the level of fitness that many of us Masters enjoy, many doctors are puzzled by it or think it might be the root cause of what ails us.

    I live in NYC where I have access to some of the best doctors in the world. I have been a high jumper for more than 25 years and when I have almost any problem, the first response I hear from doctors is “stop high jumping”.

    Recently, when I had a problem with my jumping leg, a doctor said, “Well, at least you can walk, can’t you?” And that was the end of the visit.

    I guess in the eyes of the medical world, if you are over 40 and can still walk, then you are doing fine.

  10. peter taylor - August 18, 2010

    Nicely presented, Karl. And Buzooti, you have a great attitude; I am sure you will continue to do well. But I can just imagine the scene:

    MD (not your surgeon): You ruptured it how? In the 100-meter dash? Are you the oldest member of the US Olympic team?

    Buzooti: No, I am not on the Olympic team, and I am too old to be a college sprinter.

    MD: Then why are you sprinting? How can you be a sprinter if you are not in college and not on the Olympic team? If you wanted to run maybe you should have entered these things they call 10K races; I think they are about 6.2 miles. Wouldn’t have hurt yourself so badly. Sprinting? At your age?

    Buzooti: Thanks, Doc.

  11. Cornell - August 18, 2010

    I couldn’t agree with the writer more. After bursting into the mens 40-44 with world relay records and four WMA medals (’03-’04), I have only completed 4 races due to injuries but I still think the next year will be better. I couldn’t imagine not running the 4×400 at The Penn Relays or talking with Sal and Kettrell about our training or just busting my but doing repeat 500s.
    My frineds think that I’m crazy but they also want to be as youthful looking as most of us are. I will always love this sport and therefore will never stop trying to participate in it.

  12. Don Drummond - August 18, 2010

    ALL words of inspiration. Feels good to be in shape and challenge our body and mind. Had several College and High School coaches ask if I had any years of eligibility. Even though I know they were joking I knew it was only a compliment.

    It feels good to know that we all go through the same or similiar issues when visiting our Doctor’s. This has really helped me in knowing that I am not in this all by myself.

  13. Dan Murdock - August 18, 2010

    In the past 12 months, I have been to a GP, orthopedic surgeon, physiatrist, chiro, PT, and the latest was massage therapist. 4 of 6 said I need a hip replacement. Gotta keep trying until you find the answer!! I always feel like I can make it “one more season”. Thank you to the others for their thoughts – your words are inpirational.

  14. Liz Palmer - August 18, 2010

    Hmmmm….I’m definitely going to doctors with the right mindset. My GP, OBGYN, and chiropractor are all athletes at a notable level of accomplishment and they all encourage my crazy sprinting and hurdling habit. My husband is another good example….although he is no longer in private practice, he has said that he enjoys and admires the level of fitness achieved by participants in masters track and field. He wishes that many of the patients he saw as an oncologist had engaged in more exercise…obesity and poor overall health inhibited their course of treatment and recovery.

  15. Byrke Beller - August 18, 2010

    I suspect that there exists some generational bias at play. Meaning, the older the doc, the less likely the MD will be open to Masters competition. It is also true we get VERY little sports medicine training in medical school and residency, especially if we don’t choose Ortho or Physiatry. I will also admit that my approach to the sports-related issues that come up in my practice has changed since getting back into Masters running. Docs won’t really “get it” unless they are, or have been a serious cmpetitor. Just the way it is.

  16. Bubba Sparks - August 18, 2010

    I’m in a little bit of unique situation in that my business is partnering physicians with private practice physical therapists in order to expand both practices. We have nearly 400 contracts in 46 states so I’m always on the phone with, or seeing these specialists all of the time.

    I find no shortage of active physicians who “get it” about us and really offer solutions and encouragement. That doesn’t mean I am hurt any less but it does mean I get answers and great care when it does happen.

    But the original topic is correct – I will not stop pole vaulting just because I get hurt. Two Achilles surgeries benched me for three years and a serious infection after my second one nearly cost me the bottom half of my take off leg. I had “retired” and my physician challenged me with “WHY?” Have a great evening! Bubba

  17. Fidel - August 18, 2010

    Yeah, get a second opinion. Using myself as an example, I had pain in my knee a few years ago that wouldn’t go away, I actually felt it 24/7. After an MRI (those are hard to get), the doc said the scans, and knee looked fine. Prescribed PT. The pain didn’t go away so I got a 2nd opinion. The 2nd doc said there was a noticeable tear in my meniscus. Two professionals, two different opinions. I will offer this advise: Don’t train and run marathons…. kidding…maybe…:-).

  18. Tommy Aunan - August 18, 2010

    I think I have been very lucky in finding the combination of summer and winter sports in racewalking and xc-ski racing which is a great combination. I have been competing in Master Competitions since 1999 and been in every USA Masters Outdoor Track and Field Championships since 2000. In my training and preparation I use racewalking, elliptical trainers, skiwalking with poles, and pool jogging and pool aerobics with weights. Because of this variety in my training methods and preparation I have not needed to sit out any championship in 11 years with an injury. I also focus on core strength exercises and specific strength for xc-ski racing besides xc-skiing in the winter. Variation keeps training interesting and prevents injuries. My .02 and go knock on some wood.

  19. Michael Daniels - August 19, 2010

    Roger Pierce in an article found on this website about two months ago wrote in answering a question about training, in short, said he just does enough on the track to basically get the juices flowing. It completely changed the way I trained this summer during June and it worked. I was simply doing too much and needed more recovery time between workouts. I also cut my workouts in half. Thanks to Roger I improved by doing less. In masters track and field we have to find our physical recovery zone which changes every year. Recovery time between workouts and recovery time between meets are the key factors of success. Thanks to Roger I discovered I needed to back off my training and take more recover time. Our body needs more time to recover as we get older. We have to find out what that value is as we train and compete. I discovered ( Less is More )

    Maybe Roger or Ken Stone can refresh my memory about the article.

  20. buzooti - August 19, 2010

    Bubba Sparks,

    Thanks for sharing. I really appreciate the inspiration.

  21. Ken Stone - August 19, 2010

    Here’s one of my favorite posts on Roger:
    http://masterstrack.com/2008/04/2523/

    Another good one:
    http://masterstrack.com/2008/04/2544/

    Forum may have some extra info on Roger’s training.

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