Linsanity Update: Overtraining

Jeremy Lin, point guard for the New York Knicks Basketball team, will be out for at least six weeks for surgery due to a chronic meniscus tear in his left knee. 

One drawback of having a shortened NBA season is that there are less days of rest between games.  Players are constantly getting injured and most of those injuries never make it to the media’s attention.  These cumulative injuries, which occur during the normal course of a game, fail to heal in time for the next game.  After another plane ride and a game the very next evening, the injured body part is forced to perform at 100 percent, which is often impossible. 

In order to perform, the athlete must subconsciously use other muscles to compensate for the injured part and often times this is when a more serious injury may occur.  I wonder if he would have had to have surgery if his minutes were limited.  But in the world of professional sports, that kind of an idea almost seems strange, since it is an athlete’s "job" to play.   

Overtraining, which occurs when the volume and intensity of an individual’s exercise exceeds their recovery capacity, is a common in many sports.  In some sports, such as baseball pitching, there are guidelines in to regulate how many pitches are being thrown in one day, as well as the number of rest days between pitching.   As an example, USA Baseball Medical and Safety Advisory Committee recommends a 75 pitch-limit per game, and 125 pitch-limit per week for 13-14 year olds. 

When it comes to the epidemiology of injuries, one athlete participating in a single game or practice equals one exposure.  The more exposures a person (or animal, for that matter) faces, the greater the likelihood of injury. 

You might have heard about the increased awareness of ACL injuries among female athletes.  One of the main reasons there is an increase in awareness is because there has been a rapid rise in the number of ACL injuries in females in the last 30 years.  There are numerous factors involved, but one fact is that there has been a 10-fold increase and a five-fold increase in high school and college athletic participation, respectively. Bottom line is, the more you play, the more chances you have of getting hurt.  Injury occurs from both increased exposure and from failure to recover.       

So what does that mean for the average person?  I’m not suggesting we all stop exercising because of fear of injury.  What I recommend is that you listen to your body.  Let’s say in your prime, you could run three miles a day, six days a week without any trouble at all. 

But now you find yourself having knee pain and stiffness the day after, which impacts the next day’s run. There is a possibility that there is arthritis (cartilage damage) in the knees.  If that is the case, putting more high impact stress on the knees will further the progression of the arthritis.  My advice would be first to determine what the cause of pain is.  Not everyone has arthritis as their cause; sometimes it is to take a rest day from running and if needed do a low-impact cardio exercise or cross training instead.   

For parents of children participating in sports, be aware of soreness that does not seem to go away or reproducible pain during higher impact activities.  Particularly for single-sport year-round athletes, there may be an increased risk of overtraining, as compared to those athletes who participate in different sports each season.  For example, gymnasts and cheerleaders can develop back pain from something called spondylolisthesis, which is a type of spine fracture. 

I think it’s important to weigh the benefits versus risks of certain activities.  Taking a step back and looking at the bigger picture may help in deciding what activities we might want to consider ‘retiring’ from, and which ones are worth continuing.  For professional athletes whose livelihood depends upon performance, playing in spite of risk of further damage is probably a sacrifice they feel is worth making.   

For the rest of us, who may be recreational athletes, it may be time to discuss with a health professional if it’s time to take a pit stop.  Sometimes it is difficult to figure out what is regular post exercise soreness and what is pain that signals a deeper problem.  When in doubt, consult your doctor.  Your doctor may utilize imaging such as X-Rays, ultrasound or MRI to help pin point what the underlying problem is.  With this information, a prognosis and more precise exercise prescription can be given.   

As for Jeremy Lin, already the league's most infamous underdog of the season, I sincerely wish him the best and a long and productive NBA career.  If the meniscus surgery was indeed minimally invasive, then he should be able to play again in the next few weeks.  Granted, it's playoff time, and I surmise he would have to play with a little bit of rust, so that it might make more sense to wait until the offseason to start playing in scrimmages.