The Real Heal

A nagging sports injury is a formidable opponent. Here's what I learned defeating mine.

Words of Hurt: The three types of athletic pain

ACUTE: The sensations that arise when, say, you twist your ankle are healthy. "Acute pain prevents us from getting into worse situations," says Dr. Brooks Rohlen, of the department of anesthesia at Stanford. (The few people who don't get the message, those suffering from a rare condition called congenital insensitivity to pain, are usually dead by their thirties.)
NAGGING: Acute injuries that fail to heal properly, or aches caused by overuse, bodily imbalance, and improper athletic technique.
CHRONIC: Nagging injuries that last more than six months and can eventually be debilitating. "I have chronic lower-back pain," says Rohlen, "and if I could fix it with a power drill, I'd do it."

LAST AUGUST, I had a run-in with some local pavement when my bike slid out. There was a pop in my knee, which I treated by ignoring. Having grown up in baseball cleats, I don't put much stock in noisy joints. So I did what came naturally: I rested for two days, then went hiking, bricked my way through pickup basketball, and stomped around a trade show in flip-flops.

Soon my knee resembled overripe fruit and was moving like an old VW gearshift: clack. An MRI showed nothing, but a physical therapist provided a grim diagnosis: The fall had caused my patella to track improperly, leading to a mean case of tendinitis, or inflammation of the connective yarn under my kneecap, i.e., a burr that refused to relent, no matter how diligently I settled into my couch and inhaled Advil.

It turns out my belly-up approach was dated. New research is proving that the best way to treat nagging pain is to eschew pampering in favor of tough love. Doctors at the University of Pittsburgh are doing ongoing research showing that stretching irritated tendons actually reduces inflammation. And the principle extends beyond rickety wiring. Every expert I spoke with told me variations of the same thing: "Rest and ibuprofen cure few injuries," said Dr. Jeanne Doperak, a sports-medicine physician at the University of Pittsburgh. "During rest you're in a non-healing zone," offered Dr. Phelps Kip, an orthopedic surgeon and U.S. Ski Team physician. "The body was designed to move."

This is a radically simple and promising solution for lingering athletic injuries. Difficult to diagnose and tougher to mend, recurring aches usually arise in one of three ways: mechanical injury, such as my tumble; repetitive microtrauma (think running in shoddy sneakers); or imbalances in the body's kinetic chain of movement (a weak core can cause lower-back pain). When athletes ignore nagging pain, it sticks like credit card debt.

And it just so happens that tendinopathy—chronic tendinitis—is the most diabolical of recurring injuries. Give me a broken foot over tendon trouble any day—when something snaps, at least you know what you're in for. My injury dragged on into winter, deep-sixing my mood. This is not uncommon: The link between pain and depression is so well established that sports psychologists use a tool called a Profile of Mood States to monitor injured athletes. (This is a graph evaluating tension, depression, anger, vigor, fatigue, and confusion. People in pain score extremely high in every category except for vigor.) I was five years removed from being a college athlete and I was Long John Silvering it up stairs at work. Strange questions crept into my head: Could I consider gardening exercise?

After four months of occasional physical therapy, plus lots of resting and regressing, I finally began a strict therapy regimen. Lunges taught the kneecap to track properly; stretching loosened up my knotted glutes. Every day I did 30 single-leg squats—eccentric moves that strengthen the tendon and break up scar tissue. This hurt—which meant I was doing it right. "There's going to be soreness from remodeling the tendon," Dr. Ed Laskowski, co-director of the Mayo Clinic's sports-medicine center, explained later.

Two months in, I'd built up to plyometric exercises like box jumps and cariocas and felt ready to test the patella with some three-on-three hoops. The knee continued to click—still does—but after a thorough warm-up, it didn't hurt.

I called next, drove right, and pulled up for a jumper. The ball clanged off the rim, short, and rolled out of bounds. I was back.

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