Playing With Pain Is The Wrong Message.
The badge of honor of athletes playing through discomfort comes at a high cost at all levels of sport participation.
The year was 1984, and this cowboy was at his first university hockey training camp. After 2 weeks of non-fun, intra-squad games started. Shortly in, I got thumped along the boards pretty good and saw stars. I kept playing. I came back the next day despite the resulting headache. And made it through camp, luckily not getting hit like that again. The significance of the event only dawned on me years later, I had a concussion. There was no athletic trainer at camp back then. The norm was to keep playing, regardless of the discomfort or injury.
My son is currently a college athlete and they has 3 athletic trainers at each home game with at least 1 travel with them. In his Coaching and Group Dynamics course one of the topics presented to the students was a dilemma in which the young coach had to deal with an injured youth athlete and the parents wanted him/her to play. What was the coach of a youth team to do?
Times have changed since 1984, with a lot of awareness around head injuries and sports injuries in general. Yet, there is playing with pain is a big topic for youth athletes.
Athletic identity, fear of devaluing one’s self-estimate, fear of important others losing interest, fear of upsetting important others, and approval of withstanding the risks of pain and injury in sport are all positively related to perceived pressure from significant others to play through pain. This was studied in young athletes aged 11-18 recently at the University of Northern Iowa.
Many youth sport organizations have first aid and a medical emergency protocol process mapped out for the time of injury, but few have protocol around treating and return to play standards.
Scenario 1 has our young athlete take visibly shaken up as a result of a collision. While concussion awareness protocols have improved, many sporting events do not have support personnel in place to spot and identify issues that require a time out.
Scenario 2 has our young athlete showing up for competition sore or visibly compromised in moving around. Coaches is now faced with diagnosing and deciding if appropriate for our athlete to play. Often this occurs with the athlete insisting “they are fine.”
Scenario 3 has our young athlete returning from injury with no proof that their bodies are ready to play other than “doctor said was ok”.
Then we throw in the bravado of playing through discomfort. The concept that athletes must be able to play through pain to excel. While the case can be made that self-growth occurs partially through being out of comfort zone, the exception would be playing through injury and soreness. At the formative ages, while the athlete is growing, the effects playing through injury can be devastating. Long term injury, inability to come back to play and reliance on pain medication being at the top of the list.
Where does this narrative of playing through pain come from?
From the highest level of sport, both male and female, athletes are under pressure to perform. From Olympic competition where athletes train a lifetime for a short competition window to the professional athletes on TV who risk losing their job if they don’t play. These are the standards that our young people see every day. Unfortunately, even at the highest level of sport, the consequences of playing through injury come at a high cost.
Behind the scenes, the data is compelling when it comes to the effects of playing through injury and pain.
The head injury topic has been well documented in recent years with increased awareness of CTE. Chronic traumatic encephalopathy (CTE) is the term used to describe brain degeneration likely caused by repeated head traumas. CTE and its awareness have resulted in steps being in place to assist and support head trauma and concussions awareness and treatment protocols.
The other significant repercussion is the use of pain killers to allow athletes to play through pain. It is a standard that is commonly idolized as “doing what it takes” to compete and support your teammates. It starts with advil and gets progressively worse from there.
Recently, a 25-minute documentary on the high cost of using pain killers in professional hockey. (Link below).
What can be done to minimize the temptation of playing when the youth athlete is not ready?
· Make “playing through pain” unacceptable. Youth sport organizations have the power to set a protocol for reporting and dealing with injuries. A process on requirements to play needs to be the norm at the youth level.
This is accomplished through increased training for all stakeholders, including parents and athletes (not just coaches). This training creates scenarios and develops necessary steps that minimizes risk in participation.
· Reduce the focus on the BIG GAME. The BIG GAME is capitalized because it represents the self- imposed importance organizations place on the BIG GAME, and resulting fear of missing out (FOMO). Missing the BIG GAME or tournament due to pain is a small price to play as opposed to long term injury. The more youth sport evaluates the process of development rather than working towards 1 event, the less pressure there will be for the athlete to play “no matter what” in the BIG GAME.
This requires a mindset shift. This requires standards to be communicated and expectations set early. Improving health through regular physical activity is the biggest positive outcome that can come from youth sport. Ignoring injury or soreness jeopardizes this at so many levels.
· Continue to grow the emphasis on young athletes being physical and mentally prepared for competition. Not all injuries can be avoided, but many overuse ones can. Elite teams monitor games missed due to injury by their athletes. Should youth organizations do the same? There were summers in my son’s youth baseball where I counted over 50% of the kids playing with sore arms or having to sit out completely due to overuse injuries.
Changing the mindset around encouraging athletes to “play through pain” as a sign of character would be the #1 area to focus on.
It is not a “badge of honor” to play through pain at any age.
Every stakeholder, athletes included, should watch the below documentary. They may recognize the issues. They are an issue at all levels of sport.
The below is about professional hockey but rest assured it applies to all sports where compensation is tied to performance.