Injury Prevention for the Extremist

Bilateral tibiofibular stress fractures: the four words that cut my freshman collegiate lacrosse season in half. Minor cracks in both shins that produced excruciating pain with every strike of the field—a pain that I aggressively pushed through for months and unfortunately, something that could have been prevented. I vividly recall the feelings that this new reality plagued me with and I couldn’t decipher if my injury, or not being able to play those final games, stung more. After finally accepting that I could not reverse what had occurred, I set out on the journey that every injured athlete must conquer: rest and healing. Within this process, I conducted applicable research to set myself up for success before heading into my second season. Within those following months, I implemented tangible actions into my routine to assist in recovery and future prevention.

1. Vitamin and calcium levels

The first action I sought out involved learning about my own calcium and vitamin D levels. Given that these are critical components of bone health, getting to the root of the issue felt like the appropriate first step. As reference, the normal range for vitamin D is between 20 and 40 ng/mL and 8.5 to 10.2 mg/dL for calcium. Both of my resulted levels were well below the threshold, providing me with reassurance of factors that were finally within my control. Additionally, encouraging studies suggest that the prevalence of stress fractures decrease when athletes supplement daily with 800 IU of vitamin D and 2000 mg of calcium. With this discovery and in discussing further with a naturopathic provider, I was able to safely add both supplements into my daily routine to assist in raising my current numbers. Furthermore, after discerning that vitamin D levels can potentially impact an athlete’s training efficacy, I made sure that routine blood work included this significant lab value. Current research also suggests that athletes should maintain a serum Vitamin D concentration of ≥ 30 and preferably ≥ 40 mg/ ml, providing me with a specific target to aim for. While this alone may not have been the sole factor in the outcome of my stress fractures, it was easily something that could be manipulated and improved with the addition of supplementation and proper dietary changes. Within a few months of making such modifications, I was able to successfully increase these overall lab values.

2. Proper footwear

Another undertaking I set out to discover was how I distributed the weight of my body. Through the use of a foot scan, I was able to understand my overall postural health, the level of my arches, and the degree of pronation in both feet. This information provided additional insight into where my weaknesses could be affecting the rest of my joints and the way in which I make contact with the ground. Following the test, it was beyond evident that imbalances in my feet were leading to compensation throughout the rest of my body. After doing some investigation on the success of inserts, I learned that in relation to my current situation, insoles may lower stress fracture rates by improving biomechanics, lessening fatigue, and attenuating impact. Based off of the findings, I was fitted to an orthotic designed for the exact specifications of my feet and gradually incorporated them into my daily routine. With time, I began to note drastic improvements in pain levels and stability.

3. Increasing gradually

Unfortunately, what may have been one of the main controllable factors that contributed to the cause, was the lack of pre-season conditioning. Having been a midfielder, mileage accumulated quickly in between sprints and abrupt stops, causing a great deal of force on joints that were not quite equipped for such impact. Having gone from essentially 0 to 100 rather rapidly, I wanted to be sure that this did not occur for subsequent seasons. Once I was cleared to progressively add activity back in to my regimen, I made the decision to train for a half marathon in order to gradually acclimatize my body for season. Doing so on my own terms allowed me to truly listen to the needs of my body, slowing down when necessary and adding mileage when proven ready. This decision was also built upon knowing that the end result would not only strengthen muscles, joints, and ligaments, but also my cardiovascular endurance.

4. Don’t push through pain

The final, yet most intricate solution that I integrated into my recovery blueprint involved coming to terms with and working to reverse a personality trait. Having always had a high pain tolerance and a resilient temperament, complaining about discomfort was not something I gravitated toward. I realize now that there is a significant difference between pushing past expected soreness and attempting to play through aches that do not dissipate. However, I learned that this is a fairly common theme among players given that there may be a culture within a team that is not conducive to athletes feeling comfortable to report injuries. Therefore, strategies to create more open forms of communication need to be adopted and assimilated into sports teams at every level in order for occurrences similar to mine to be mitigated.

Despite the misfortune that coincides with musculoskeletal injuries, the silver lining for me was that it instilled the incentive to explore and implement various methods for longevity, on and off the field. Additionally, it sparked a passion and desire to learn more about the health and wellness industry and the disparity that exists in athletes and injury prevention. My experiences with injury and the process that I took to combat it ultimately guided me toward a career in healthcare, with a craving to assist others in circumventing the path that temporarily interrupted my collegiate athletic career.