I want to start with the irrational sport’s fan in me is ecstatic and feels as though my prayers have been answered with sports coming back. However, the physical therapist, researcher, and data driven part of me is nervous, scared and critical of the decision. Every day it feels as though a new college athletic department, professional sports team is suffering from the devastating effects of Covid-19. To name a few Clemson University , University of North Carolina, Kevin Durant, Patric Ewing, Nikola Jokic, Ezekiel Elliot, etc. However, there is another player safety concern that the mainstream media and the general population as a whole is not focusing on; These athletes may be at a significantly higher risk to suffer severe career altering injury.
As we all know the world has been shut down for the last ~4months, and the sports world is no different(unless you are Tom Brady, but going down that path would be like going into the wrong house). Most people in the media have made the argument that this extra rest will help players recover from injuries and will help the players be refreshed from the extra time off; and this may be true for players that were suffering from nagging injuries. However, it does not take into account the inability in the timeline of return to competition for athletes to get their training workload and intensity to match that of game and practice.
Covid-19 is in a league of its own in how it has disrupted sports and all preparatory training for it. To understand its possible effects we must look at situations that have also caused disruptions to the season, with the closest examples we have in recent memory being the 2011 NBA and NFL lockout. During the NBA lockout, Tim Hewett, one of the world’s top experts on ACL injuries, as well as former director of sports medicine research at Ohio State University and former director at the Mayo clinic, was very vocal about the risk of injury these players were going to experience when they came back from the lockout. His precautionary warnings stemmed from an editorial that Dr Hewett and Dr Gregory Meyers among others published in the Journal of Orthopaedic & Sports Physical Therapy, titled “Did the NFL Lockout Expose the Achilles Heel of Competitive Sports?” In this publication they presented astounding results from the injury rates in the 2011 NFL season that was affected by the lockout. Between the years of 1997-2002, the NFL saw on average 5 achilles ruptures per year. In the first 12 days of training camp upon return from the lockout, the NFL saw 10 achilles tendon ruptures (5 were rookies, which is very interesting as achilles ruptures typically occur in athletes who are 30+ years old) , then 2 more during the first two preseason games. As Dr. Hewett predicted the NBA was no different, but saw a much greater increase in ACL type injuries. In the season prior to the lockout the NBA saw saw just 3 ACL injuries. During the shortened lockout season the NBA saw 11 players go down with major knee injuries(most notable, Derrick Rose during the 2012 playoffs).
Now that a problem has been presented, the researcher in me wants to understand the mechanism of why this significant increase in injuries is occurring. The answer is most likely multifactorial and no doubt can not be fully explained. There are some hypothesis’s that can be used to explain these results though. The number one reason is that injuries occur when the load/force an athlete experiences is greater then the capabilities of the tissue it is stressing. With this players during these disruptions in training and sport do not have proper amounts of time to increase their physical capabilities to match those needed during a competitive sports situation. Another factor that affects athletes during lockouts and pandemics is that many are unable to access the team’s medical personnel to help them recover from existing injuries, which left untreated can lead to neuromuscular deficits and imbalances. These neuromuscular impairments will get amplified during high intensity competition. Finally, players may just be “out of shape”. This may help to explain why we saw so many rookies being injured, as they do not understand what it takes to stay in professional shape.
I was optimistic that we were not going to see as large of a spike in injuries as I have heard discussions from some very smart people over the last few months on how teams can help “flatten” the injury curve. However, after the first weekend of watching European Soccer, and seeing countless injuries, the realist in me kicked in. Now I fear this disruption will be even worse. This was reaffirmed while listening to Pardon my Take’s interview with Trevor Baur, pitcher for the Cincinnati Reds, where he was discussing how many players had not been working out, thrown a ball or taken a swing since Spring training got canceled back in March. This led me to brain storm reasons why this time will be worse. Listed below are just some of my thoughts.
It is 2020 and it seems liked anything that can go wrong will go wrong.
A Lot of players did not have access to their gyms or personal trainers
Games are going to be much more intense
NBA and NHL going straight into Playoffs(basically)
Shortened MLB season(each game in theory is now worth 2.7 games)
Medical Staff may be hyper focused on Covid 19 concerns and may have limitations on how much pre/rehab they are able to do with the athletes inorder to limit interaction time.
With all this being said, we can hope and pray for the safety of all players. I hope the medical and training staff has listened to the experts, at least more than our government, to help protect our athletes against injury and disease.