In the 1996 Olympics gymnast Kerri Strug sprained her ankle on her first vault landing. All she needed to earn a gold medal was a clean vault, which was exactly what she did after spraining her ankle: Strug performed a vault with an injury, landing on one foot. Competing or performing with an injury is common in world of athletics at any level. Strug’s story, as well as many other athletes who have overcome adversity, hold not only a special place in history but also in the eyes of society. The athletes are looked up to as heroes for sacrificing their bodies for the glory of a win. This mentality contributes to the pressure many athletes face to play through an injury at all costs, and negatively contributes to their bodies and mental health. Hiding injuries and/or playing through the pain is not only hurting the injury and prolonging it, but could also lead to more serious problems later on.

From athletes’ perspectives, they are training to control and master their bodies. When injuries occur they may view it as just another part of the body that needs to perform a certain way. An injury may also cause them to view their body as something to fight against. The injury may seem like a form of betrayal because their body is not cooperating with the demands, but in reality the body is telling the host that it needs a break.

Athletes tend to avoid their injuries because they do not want to take time off. For professional athletes, playing through injuries is the norm—their sport is their job, and if they have to take time off, many feel as though they aren’t fulfilling their responsibilities. This, as well as the threat of being replaced, factors in to playing while they are injured. It’s reasonable that they play through injuries; they have everything riding on their athletic abilities. As a result, if the injury is something that won’t end their career, they will risk their health for the reward. However, even though athletes play through the pain very often at this level, they are aware of potential risks. Athletes view those who can accept that they are injured as brave. Former NBA player Alvin Williams stated, “They’re the real courageous ones, because they’re the ones who are going to be able to come back. They’re setting an example that they’re more than an athlete. And, paradoxically, that’s what’s going to make the best athlete, the best organization, the best everything.” Athletes know that playing on an injury is not the best option yet this is not what they are taught or encouraged to do.

In a study of 3,000 athletes, coaches, and parents, 42% of youth athletes said that they have hidden injuries so they could play, which could lead to more serious complications as they grow up. Kate Carr, the president of Safe Kids Worldwide sums it up perfectly, “The awareness we have about injuries and the risk to our children is not matching the behavior that we’re seeing on the field.” Although winning is an important aspect of sports, it should not be something to risk children’s health for. The restriction requiring athletes to be pulled if they have a suspected concussion and the reduction of contact and checking in youth sports are both steps in the right direction for the reduction of injuries as a whole. Now the task is to create an atmosphere where it is the norm to report injuries.

In “Playing through the pain: Psychiatric risks among athletes,” Drs. Samantha O’Connell and Theo C. Manschreck look at the vulnerability in athletes regarding psychiatric health. One of the factors that drives this is how athletes express pain (which for many cases they don’t). Hiding physical injuries could be the gateway into athletes hiding other health issues as well, specifically related to mental health. Athletes may fear that seeking help will make them look weak and threaten their status as an athlete or with their team. This could lead to further problems with their mental health. O’Connell and Manschreck state that playing through pain may be influenced by pressures from coaches, scholarships or parents, but ultimately it has to do with the pressures the athletes puts on themselves to achieve.

When athletes view injury as a weakness both to their identity as an athlete and their performance, this can cause greater health issues regarding injury as well as mental health. Advise your athletes to sit it out if they are in doubt. While sitting out may not be fun for a game or two, it is better than never playing again or having it affect you or your athletes off the field. This view of injury in professional sports may not change soon, but you have the ability to change how you and/or your athletes view injury.

Phil Hansen was going to school to become an artist when he discovered something that he thought would end his career before it even began. He had developed a shake in his hand from using pointillism—a painting technique in which small dots are applied in patterns to form a single image. Because he could no longer create art through his preferred method, he decided to drop art school and art altogether. However, years later he decided to return to art and saw a doctor about his condition. The doctor changed his life with a single question: “Why don’t you just embrace the shake?”

Hansen’s TED talk describes his inspiring journey to find his new calling through art: “And I realized, if I ever wanted my creativity back, I had to quit trying so hard to think outside of the box and get back into it.” Athletes can mirror this idea by spending time going back to the beginning and thinking about what aspects of their sport made them fall in love with it in the first place. More importantly, this talk—and what we can all take from it—is about remembering what makes us unique and what strengths we have.

As his talk comes to a close, Hansen professes: “Limitations may be the most unlikely of places to harness creativity, but perhaps one of the best ways to get ourselves out of ruts, rethink categories, and challenge accepted norms. And instead of telling each other to seize the day, maybe we can remind ourselves every day to seize the limitation.”

Everyone has a “shake” or weakness, and although this insecurity may seem like a flaw it is simply something that makes you unique. However, because “shakes” are unique to each individual, it may seem as though you are the only one with that particular “shake.” Sometimes, that results in athletes defying their shakes in the attempt to be “normal.” This perspective is understandable considering technicalities in sports require athletes to follow certain rules and regulations. As a result, it is hard for them to both accept and figure out an alternate path to take toward the designated goal. Although taking another route for the sport or skill they are working toward will be an adjustment, it will make them a stronger athlete with stronger weaknesses.

Athletes have the ability to embrace whatever “shakes” they have just like Phil Hansen. Rather than letting the shake define them, athletes can define it for themselves and use it as a performance enhancement they never knew they had. In other words they can seize the limitation in their shake. Believe in what makes you different; never give up on something just because it is not viewed as typical. Most importantly, embrace your shake.

See Hansen’s inspiring talk here.

For athletes, heart health is one of the many benefits of maintaining the active lifestyle that they do; however, having a heart with structural changes to cope with athletic demands can sometimes come with complications. Symptoms such as chest pain, dizziness, shortness of breath, passing out, and irregular heart beats are all signs to go see a doctor.

Another issue with the hearts of athletes is genetic or irregular heart conditions. Heart conditions are often undiagnosed and can lead to serious life threatening consequences like cardiac arrest while playing a sport. One of the most common heart conditions involved with causes of sudden death in athletes is hypertrophic cardiomyopathy (HCM)—the enlargement of the heart muscle to a dangerous size—which is commonly undiagnosed.

The key to keeping your athlete safe is detection. To help determine if your athlete has a heart that could potentially be at risk, be aware of familial health history and learn what symptoms to look for. If you know your athlete could be at risk, consult a doctor and arrange to have further testing done. If they don’t seem at risk but you notice your athlete begin to exhibit something similar to any of the symptoms, err on the side of caution and go see a doctor. From then on the doctor or specialist can determine what the next best course of action is. This could range from testing, monitoring athletic activity, or refraining from athletics altogether. Sometimes the best way to protect the heart is to stop athletic activity and let it return to normal size. This gives it a chance to work properly without all the stress of performing under athletic conditions.

Overall, athletes having heart conditions are nothing to panic about—just be aware. Just like you are aware of your athletes’ injuries, you need to be aware of the potential injury their hearts could have. The heart is just like any other muscle in the body that can become pulled or strained. Many people have heart conditions and can live normal lives, but being an athlete puts more stress on the irregularity of the heart, which can cause more serious issues. Remember being informed is crucial and to take precaution through prevention, detection, and diagnosis. It is always better to be safe than sorry.

For more information, check out the following links:

Hypertrophic Cardiomyopathy

Athletic heart syndrome