Dropping Like Flies at a Barbecue

Andrew Charniga

www.sportivnypress.com

Figure 1. Major league pitcher tears Achilles tendon fielding a ground ball.

A series of essays identified an aberrant rate of lower extremity injuries, especially non – contact afflictions; in American sports such as basketball, football and even baseball. A unique method of reverse engineering injury mechanism was devised to ascertain cause and effect; culminating in an essay the contents of which would seem to exclaim, enough said, move on to something else: “Subliminal Delusion and Merriam Webster”. However, unabated, the injury deluge continues.

The aforementioned essay identified such a spate  of injuries that subliminal delusion was deemed an appropriate label for the emergence of a cottage industry of various medical palliatives to address the burgeoning problem. With the emergence of so many commercial palliatives, injury tents, knee walkers, tight rope surgeries, and the like, to address the still rising tide of injuries; both circumstances, the injuries and the palliatives; were deemed part and parcel of a new normalcy. That is the subliminal delusion. 

 Consilience of Induction

Consilience of induction essentially refers to confirmation of one set of facts  confirmed from another set of facts obtained  from different circumstances. In the context of the series of essays of American sports aberrant rate of injury; most notably to the lower extremities; football, basketball and baseball are different sports with obvious distinctions; yet the injury landscape is strikingly similar. Hence, induction of cause and effect of the preternatural lower extremity rate in football is confirmed by the strikingly similar circumstances in basketball and baseball. The consilience is the linking of common threads between the activities; affirming the assumption of cause and effect from one set of circumstances to the other. 

For instance, consider the two instances of plantar fascia injury reported below. What would seem to be different and unrelated; presumably unrelated circumstances of football and basketball; two athletes suffered essentially the same injury to the plantar fascia.

The plantar fascia is a band of visco – elastic tissue on the bottom of the foot. This fascia is stretched taut when the heel is raised; creating a spring like mechanism from the base of the toes to the heel. Hence, it is a spring in the bottom of the foot which may not function very effectively when the foot is bound with athletic tape and even more so when the athlete’s shoe is bound to the ankle with even more tape. This spring in the bottom of the foot is situated in series with the Achilles and the other tendons and ligaments from foot to hip, i.e., elastic connections; a vital link of the leg spring closest to the ground. 

Both plantar fascia injuries were ‘non – contact’, i.e., sans the excuse contact with another player caused the injury. The athletes were injured participating in normal for their respective sports; the surfaces (field turf vs court) were different; the shoes were different; ages were different.

It should be emphasized at the outset a near absolute confirmation of  cause and effect exists between these two injuries and those examples which have been put forth in prior essays. The significant disparity in age of the two plantar fascia examples is a tell tale sign. Injuries such as fascia tear; and, especially Achilles injuries used to be more common in out of shape middle age men playing pickup basketball and the like; not young, fit, and otherwise healthy young athletes still in the bloom of youthful elasticity.

The elastic (compliance) potential  of an aging, out of shape athlete; is obviously in decline from lack of training; especially as a result of the process of aging itself. Understood.

However, the fascia tear (his second) of 35 year old football player whose body is probably closer to 50+ in Biological age and the 22 year old basketball player, confirms the aging effects of neither the game of football; nor basketball; but the range of motion limitations of their training and rehabilitation from injury; the range of motion restrictions of the taping and bracing. These injuries are good examples what happens “when constrained volatility choked systems explode” (Nasim Talem, 2012).

The circumstances are different; but the medicaments administered by the conditioning coaches, the athletic trainers, doctors and physical therapists are essentially the same; confirming the original theory as to the cause and effect; why court and athletic field ‘car accidents’ have become commonplace. The salient point to emphasize is the ‘elasticity compromised’ youth of the basketball player. When old man injuries crop up in younger athletes; it is a clear indication something is amiss in the training and care of these athletes. You can’t just pass it off as happenstance.   

Examples of fascia tear injury: 

The school {the university of Michigan} announced his status Friday, saying Davis (age 22 yrs) has a plantar fascia injury from a non contact movement in the Wolverines’ win over Toledo on Wednesday.”

“Olsen  (35 yrs old football player with Seattle Seahawks) went down in obvious pain without being contacted“He has a fascia tear injury that he’s had before in his other foot,” Carroll said.

Figures 2-3: Two samples of consilience of induction. Collegiate football players (photo above) do wall squats on ‘leg day’ while elite basketball player does the same exercise for rehabilitation after suffering an anterior ligament tear (ACL) to knee.

Another example along these same lines is Klay Thompson of the NBA Golden State Warriors. He suffered a season ending tear to his right Achilles tendon on November 18, 2020. This was another serious injury to the 29  year old player who suffered an ACL tear in the 2019 NBA playoffs. Two season ending injuries in successive seasons. Furthermore, this makes three players from the same team who succumbed to Achilles injury.

In the wake of this injury:

“…coach Steve Kerr and members of the Warriors’ training staff are expected to fly to Los Angeles to be there for Thompson when he gets his MRI.”

Isn’t that akin to calling arsonists to put out a fire?

He (Thompson) is depicted doing wall sits to rehabilitate the knee (the ACL tear) in figure 2. Apparently, no one stops to consider if doing such things could do more harm than good. Hence, collegiate football players training with the same range of motion restricting isometrics (figure 1) as the basketball player; who employed the same joint stiffening exercise to rehabilitate a knee injury. Thompson suffered an Achilles tear after a prolonged rehabilitation to recover from the ACL tear. The collegiate football team of the players doing wall squats in the figure; suffered an Achilles rupture in three successive spring practices: 2018, 2019, 2020; plus an additional Achilles tear in a 2020 season game.

Ignoring Consilience to Accept the Delusion of Happenstance

If science doesn’t fit in with the cultural milieu, people dismiss science, they never reject their cultural milieu! If we are involved in science of which some aspects are not commensurate with the cultural milieu, then we are told that our science is flawed,” Lynn Margulis, 2010

A range of accounts were cited in previous essays which offered various explanations from the ‘experts’, doctors, therapists, coaches and so forth; for the appearance of Achilles rupture and a litany of lower extremity injuries in the NFL. Not one of the explanations/excuses cited hold water: bigger, stronger, faster players hitting harder; not enough time working with conditioning coaches, trainers and medical staff; defective shoes; artificial turf; falling awkwardly. Every excuse imaginable other than the obvious: a lack or simply loss of athletes’ elasticity. The elastic properties of the muscle tendon complexes of these athletes prematurely erodes; failing to function as a spring like mechanism.

Over time, participation in football, basketball, baseball and other sports which are overburdened with conditioning coaches, athletic trainers, doctors, physical therapists, personal trainers and so forth; proscribing safe in the gym or therapy room exercises; over medicating athletes with braces and tape accelerate the aging of young bodies with a loss of overall compliance and muscle tendon elasticity. As the quote above indicates, the ‘milieu’  comprised of conditioning coaches, athletic trainers, doctors, physical therapists, personal trainers place the blame on existential factors; not on their care of the athletes.

In previous essays (Charniga, 2015 – 2020; www.sportivnypress.com) the effect of one false narrative that stretching ligaments causes joints to become unstable; permeated thinking from the training room to the doctor’s office, to the scientific literature over a period of many years. This situation has given rise to utterly meaningless terminology such as ankle stability. Just what constitutes ‘stability’, joint stability and of course instability in particular; has become an exercise in senseless semantics.

“The tighter the ligament the fitter the knee” Karl Klein, PhD, 1962

As a consequence of senseless semantics; in lieu of empirical evidence, a glut of university certified athletic trainers, physical therapists, strength and conditioning coaches, certification courses and other certified practitioners administer strength and rehabilitation exercises with amplitude – controlled – linear movements in joints; and so forth (see Charniga “It’s all connected parts I – III” www.sportivnypress.com).

The evolution of the original false narrative which lead to all of the above practices created conditions for the current circumstances where injuries are so common it seems normal. However, what now seems to be sudden spate of injuries across American sport has been a long time coming. As more and more sport, fitness and health practitioners have signed on to the original false narrative; training, fitness and rehabilitation practices are in lock step.

The athletes in figures 2 & 3 are good examples of different sports and circumstances with their respective ‘milieus’ are all on the same wrong page. Both elite athletes from different sports do the same dumb exercise: one for rehabilitation the other for training.

Although the spate of injuries in 2020 seems like some sudden, out of the blue incidental, it is not:

“Injury bug? No, Week 2 of the 2020 NFL season was not bitten by the injury bug. This was injury Godzilla, laying waste to the dreams of fantasy football managers everywhere. The carnage stretched from New York to San Francisco, from top overall picks to sleepers, from running backs to defensive ends.” https://www.espn.com/fantasy/football/story/_/page/TMRlovehate200924/fantasy-football-week-3-picks-sleepers-busts-rankings-matthew-berry-loves-hates-qbs-rbs-wrs-tes

 

Figure 4. Modern artificial turf which is comprised of carpet infused with beads of rubber; does not fit the dangerous surface narrative; even if there were some credence to that argument; the same injuries occur across different sports with different shoes and of course, playing surfaces.

The aforementioned practices have made old athlete syndromes like Achilles rupture, plantar fascia, car accidents (bumper fractures, foot pedal fractures); even falling off a horse fracture (Lisfranc foot fracture) commonplace in younger athletes. 

The catastrophic Achilles injury has become commonplace in football and basketball (see “Of flat tires and Brittle basketball players” www.sportivnypress); and occurs, not surprisingly in baseball (see figures 1 & 2) along with other lower extremity injuries such as hamstring pull, bicep tear and other maladies. The connecting thread of aberrant injury (see Charniga, “Subliminal delusion and Merriam Webster” www.sportivnypress.com) is the commonality of methods and practices administered by the conditioning coaches, trainers, physical therapists, doctors and of course fostered by irrational ideations from academia; permeating American sports.

When the athletes themselves acknowledge that a such a catastrophic injury as Achilles ruptures “have become more common”; the why and how this circumstance is common, is the obvious topic left out of the conversation.  

He {Kevin Durant} said there were few, if any, activities he could get through without assistance early on, and even though Achilles injuries have become more common, the rigors of relearning how to walk, run, jump and do basic cutting exercises on a basketball court shouldn’t be “underestimated.”https://www.espn.com/nba/story/_/id/30430705/kevin-durant-suits-brooklyn-nets-open-training-camp-says-feeling-good-not-holding-back

 

Figures  5 & 6. Major league pitchers suffer Achilles tear under relatively ordinary, benign conditions of fielding ground balls.

Decimated by injuries and with the new twist provided by the COVID-19 pandemic making matters worse, the Niners opened Thursday night’s 34-17 blowout loss to the Green Bay Packers with a whopping $80.8 million worth of cap space on injured reserve.” https://www.espn.com/blog/san-francisco-49ers/post/_/id/37693/49ers-suffer-lopsided-loss-thanks-to-80-8-million-in-cap-space-on-ir

A spate of injuries in collegiate football; an “injury godzilla” in pro football, basketball and the like in 2020 are discrete events. In the “injury godzilla” case, a discrete event is the result of a gradual change in procedures; acceptance of methods and treatments and such over time; where the aforementioned milieu are involved in the training and care of a young athletes from high school and earlier. Young athletes, in chronological terms; who in fact are trained to become significantly older in Biological years (with less elastic potential); are burdened with an overhang of enhanced injury susceptibility from  injuries; some resulting in surgeries incurred in junior high, high school and college. Consequently, those who are fortunate to enter the professional ranks do so with less and less useful longevity.

Figure 7.   Young female weightlifter displays large range of motion in hips, knees and ankles. Charniga photo.

Unlike American sports training where athletes can engage in strength training that can cause joint – muscle – tendon – ligament elasticity issues; weightlifting training can start as early as 10 years old; even with females; employing techniques to cultivate and enhance the injury resistance properties of joint – muscle – tendon – ligament elasticity. For example, the general aims and emphasis of training for weightlifting before age 13 to age 20 are presented below from Soviet/Russian sport scientist L.S. Dvorkin.

From the onset of training there is an obvious emphasis on cultivating speed, flexibility, dexterity up to an including age 18; so as to take advantage of the young body’s natural elasticity, the presence of which greatly facilitates the acquisition of coordination and various sport specific skills.

Contrast the Soviet methodology with American kids doing powerlifting/bodybuilding exercises with machines and otherwise slow moving exercises with relatively small movement amplitude, i.e., anti – skill, dexterity, flexibility exercise.

From the book: Weightlifting and Age, L.S.Dvorkin, FIS, Moscow, 1989; English translation Sportivnypress, Livonia, Michigan

Up to age 13

  1. Mastering technique
  2. The development of speed – strength qualities, speed, dexterity, flexibility

Ages 14 -15 years

1.Improvement of technique

2.The development of speed – strength qualities, speed, dexterity, flexibility, general and

3.special endurance

Ages 16 – 18 years

1.The development of the special physical qualities of the weightlifter: speed – strength,

2.speed of execution of the exercises, special endurance.

  1. Perfecting the technique of the weightlifting exercises (especially the classic)

{exercise samples for this stage : 20 – 100 m sprints, long jump, high jump, acrobatics,

exercises for flexibility, joint mobility and to strengthen the tendons and ligaments}

Ages 19 – 20 Years

1.Development of the special physical qualities of the weightlifters

2.Perfecting technique and reliability of execution in competition

3.Differentiation of strength and speed strength training, taking into account individual

differences; more intense training of individual muscle groups.

The incidence of injury becomes (seems) high in the pro ranks; because the pool of athletes whom have suffered a prior injury; and, consequently have increased susceptibility to further injury; continues to rise, such that there are more participating at the lower levels of sport. If anything academia adds more wrong pages to follow; further fueling the fire.

Table 1. Some lower extremity injuries in the NFL over the progress of the “injury godzilla” 2020 season.

Date Below Knee Knee Total IR
9/24/2020 66 74 140 158
10/17/2020 80 70 150 222
11/5/2020 98 90 188 259
11/19/2020 104 96 200 291
12/3/2020 107 111 218 311
12/26/2020 117 116 233 324
12/31/2020 138 123 261 350
1/6/2020 125 104 229 371
2/8/2021
111
99
210
435*
  • Below knee: injuries below knee;
  • Knee: knee injuries (ACL, MCL, meniscus);
  • IR: injured reserve;
  • The number of players (435*) who are questionable for training camp.

Presented in table 1 is a list of injuries in the NFL from the first weeks of the season to the end of the regular season. In keeping with the general thematic of this injury incidence and susceptibility series of essays; probable cause can be traced to exercise techniques, taping of ankles and feet, and rehabilitation techniques. The injury categories listed in the table are only those from the knee down and knee injuries. The combined total number of below knee and knee injuries essentially doubles as the season progresses. The same picture occurs with the IR (injured reserve) list.

However, at the end of the season (2/8/2021) the number of players who may not be ready to participate in training camp spring are listed as 435 instead of IR. The overall injury incidence in the NFL of various categories is not comprehensive of these data in the table. An unknown quantity from the data in table 1 relates to how a lower extremity injury; and especially, return to play after rehabilitation affects susceptibility to another injury; even concussion.

However, probably the most important factor missed by those involved in the care and training of these athletes (football, basketball, baseball players, soccer and so forth) is the effect of training for these sports over the long term; from middle school to the professional ranks. As these car accidents  such as tibial plateau fracture; falling off a horse (Lisfranc) foot fractures, middle age men playing pick up basketball blowouts (Achilles ruptures) become all the more commonplace the obvious question to ask is the Biological age of the injured athletes out of sinc with their chronological age?

That is to say, over a period of years, participation in sport training and potential rehabbing after injury; is the body of a collegiate football player, for instance, who enters the pro ranks at chronological age of 22; is in fact, 28 or 29 years in Biological age; with depleted joint mobility and loss of muscle – tendon elasticity.

Generally those involved would dismiss such speculation because their approach is to apply tunnel vision; an ankle injury, for instance, is to the ankle and would have no connection to a prior, subsequent injury, or prolonged strength training with joint stiffening exercises.

It is of interest to note that the original article of this series (“Achilles tendon rupture and the NFL”, Charniga, www.sportivnypresss.com) examined the alarming incidence of Achilles tendon ruptures; when this rarely seen injury in young people rose to 4 – 10 over the course of the NFL season became the norm. Now it would seem the ‘norm’ has jumped to 18; to an almost a two – fold increase within a relatively short time.

The single unifying element, or consilience of induction, interconnecting the incidence and the rejuvenation trend of younger athletes succumbing to these injuries is the common practices the affected sports share in terms of conditioning and medical attention.

 

References

/Charniga, A., “Subliminal Delusion and Merriam Webster”, www.sportivnypress.com

/_/id/30430705/kevin-durant-suits-brooklyn-nets-open-training-camp-says-feeling-good-not-holding-back

/ https://www.espn.com/fantasy/football/story/_/page/TMRlovehate200924/fantasy-football-week-3-picks-sleepers-busts-rankings-matthew-berry-loves-hates-qbs-rbs-wrs-tes

/ Werkhausen, A., Albracht, K., Cronin, N., Mewier, R., et al, “Modulation of muscle – tendon interaction in the human triceps surae during an energy dissipation task” Journal of Experimental Biology (2017) 220, 4141-4149 doi:10. 1242/jeb. 164111

/ Holloway, M. “The female hurt”, Scientific American, 11:3:2000, 32-37