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A World of Hurt
Today's high-stress sports injuries may leave you longing for the carefree days of "Help, I can't get up!" By McKenzie Funk

Two years ago, climber and physician Harry Adelson was at a conference where a diagnostic ultrasound device was being demonstrated. "I had him put the transducer on a finger that was bugging me. It showed that the ligaments around the joint were damaged. He tried the next finger, so I could see the difference, but I'd partially ruptured that one, too. After he tried a third, he looked up and asked, 'Are you a climber?' "

Outdoor sports have changed, and with them sports injuries. To be sure, falls—a bike crash, a slip during a kayak portage—still cause the most injuries. But athletes are also being hurt by poor technique and overtraining—and in new ways.

Injury: Metatarsal bursitis (inflammation of the fluid-filled sacs in the balls of the feet)
Cause: Steep climbs and uneven ground
Prevention: "Proper shoes are always important," says foot specialist Perry Julien, "but they're even more important for the unforgiving terrain of trail running." Aside from providing heel stability and ankle support, trail runners have a well-padded forefoot (try www.aapsm.org for recommended models). If bursitis does set in, place a foam pad behind the ball of your foot, toward the arch, to take the pressure off. Ice often.

Injury: Dislocated or partially dislocated shoulder
Cause: While white-water paddles have gotten shorter and less feathered in the past decade, resulting in fewer torque-related wrist injuries, the danger for shoulder dislocation remains unchanged. Paddlers who let their arms stray too far back, especially less conditioned newbies (1.3 million sampled the sport in 2002), are at risk.
Prevention: When paddling, keep your arms "in the box," says Gordon Black, director of safety education for the American Canoe Association. "The back of the box is a plane in line with your back. The sides are as far out as you can reach. The front is as far forward as you can reach. The top is your head."

Injury: Chondromalacia (irritation of the cartilage behind the kneecap)
Cause: The advent of mountain bikes—particularly those with low saddles that cause the knee to bend excessively at the top of the pedal stroke—has made this classic cyclist's injury more acute.
Prevention: Raise your seat for flats and climbing, try to keep your pedaling cadence above 90 revolutions a minute, and use clipless pedals that give your foot a degree of lateral motion. Work your gluteals and medial quadriceps in the gym. If chondromalacia persists, a custom bike-fitting from an orthopedist may be needed.

Illustration: Damage to finger ligaments and tendons
Injury: Damage to finger ligaments and tendons
Cause: "In a gym," Harry Adelson says, "you can climb as long and hard as you like." (Artificial walls now number more than 700 in the U.S.) The thing is, many climbers don't know that they shouldn't visit every day. "By weight, ligaments are stronger than steel, but they're not infallible. If you overtrain them, [damage] can be permanent."
Prevention: Over the past year, Adelson has kept his climbing to two days a week, and his level has improved markedly. "It's just like in body building," he says. "Those guys know you don't get strong from training, but from resting—that's when you lay down new collagen." Novices should keep their days short and build toward goals; clawing up a route that's too much for you is a surefire way to tweak a finger.

Illustration courtesy of Zohar Lazar

From the print edition, June/July 2004

Grail Trails: The Appalachian, The Pacific Crest, and The Continental Divide
Off the Face of the Earth: Holocaust survival in the underground labyrinths of western Ukraine
Southbound on the Mekong: The pristine mountain jungle, ancient Khmer ruins, and sacred Buddhist caves of tiny Laos
Health: A World of Hurt: What's ailing the next generation of outdoor athletes

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June/July 2004

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