Playing Hurt: Is it Worth it?

As you may or may not know, I - Ciana - recently ran a marathon. It was quite anti-climactic because I passed out and can’t remember anything after 41km (1.2km to go). I remember feeling significant discomfort at around 32km and I said, out loud, ‘I want to stop so bad’. I didn’t stop. I thought to myself ‘this is how it’s going to feel... Don't listen to yourself. You can do this.’ Afterward, I had many people tell me how impressive it was that I had pushed through and kept going, and how I was practicing what I preach; pushing past those unhelpful thoughts and doing the thing anyway. 

This got me thinking about how we as a society view athletes who push the boundaries of their bodies (and minds) to play through pain and injury. It's not hard to find newspaper headings and online articles about these “badasses”,  “warriors”, and “heroes”.  

This phenomenon of playing through injury and pain is called ‘playing hurt’. Playing hurt is a common occurrence in pretty much all sports and at all ages. 

•  In the GAA, 50% of players played a club game and 35.5% played an inter-county game while injured (Kelly, Banks, McGuinness, & Watson, 2018).

•    Up to 50% of concussions go unreported by athletes (McCrea, et. al., 2004; Meehan, et.al., 2013). 

•  Recent studies show that children as young as 11 as actively hiding and playing through injuries (Whatman, Walters, & Schluter, 2018). 

Why do athletes play hurt? 

The answer to this is most certainly not black and white but some factors can contribute to an athlete’s decision to play hurt; sport ethic, pressure, and athletic identity. 

1. First, Sport Ethic, in a way, refers to the unwritten rules and expectations in competitive sport. According to sport ethic, athletes are expected to accept the risks and play through pain (Hughes & Coakley, 1991). Athletes are expected to 'walk it off', 'take it like a man', and 'put on a brave face'. And, this is accepted. This is normal. The interesting thing about sport ethic is that most people have probably never heard the term (I hadn’t until I found my way into this field), but most people follow these rules, anyways. 

2. Second, Pressure can be both internal and external. Internal pressure can surface due to those unwritten rules (see above) and due to athletic identity (see below). External pressure refers to how these athletes are viewed by their teammates, coaches, experts, and the media. 

Think about the way we as a society describe individuals who play hurt. Think about how we talk about ‘winning at all costs’ and ‘putting in all on the line’. Not only are athletes expected to play through injury but they get rewarded for it too. Athletes who accept and play through injury are more accepted by their coaches (Malcolm, 2006), teammates (Malcolm, 2006), experts (Albert, 1999), and the media (Nixon, 1993). 

Let’s look at two examples: 

1. One of the most iconic stories about Tiger Woods is about when he won the 2008 US Open while walking 91 holes on a torn left anterior cruciate ligament and a stress fracture on his left tibia. It was unknown to the public that Woods was suffering from these injuries. When it was revealed, his victory was elevated to another level of heroics. 

2. A little closer to home, one example is Bernard Flynn, who played for years while suffering from a serious hip injury. During his time in the Meath jersey, he won two all-Irelands. 

While I can’t speak for these individuals and why they played hurt, I can tell you that some of the most common reasons for athletes pushing through are: 

•  Not wanting to let down their teammates. 

•  Not wanting to lose their place on the team. 

•  Not wanting to be seen as weak by others. 

3. Third (but by no means the last reason), Athletic Identity is the degree to which an athlete identifies with their role as an athlete and seeks acknowledgment from others for that role (Brewer, Van Raalte, & Linder, 1993). 

If an athlete ties themselves, their self-worth, and their standing in the world to how successful they are in sport, this can build internal pressure. They may play hurt because they can’t (or won’t) accept taking time away from their sport and they don’t know who they are or what they will do without their sport. 

Remember how we describe athletes who play hurt in the media? Well, an athlete with a strong athletic identity may also be tied to the recognition they receive for their participation in sport so think about how tempting it might be to be seen as a ‘hero’ for that individual … another reason an individual might play hurt. 

Is it worth it? 

Playing hurt is what's expected. Playing hurt will get you noticed and applauded. Playing hurt and winning will make your win even more significant. Playing hurt will gain you respect amongst your peers, your coaches, the media, and the general population. 

But, at what cost?

Tiger Woods didn’t play another tournament in 2008. He kept re-breaking his leg as he attempted to force a return to play. 

Bernard Flynn was forced into early retirement before he reached 30. In an interview he speaks of the incredible pain he endured during his career for ‘fear’ that he would lose his position on the team. Even after retirement, he struggled for years, falling often due to pain, having his wife help him get dressed, and even being left immobile, before finally undergoing hip replacement at the age of 42. 

For me, I can’t remember anything after 41km (1.2km left to go). I passed out due to severe dehydration and woke up in an ambulance. 

That side of playing hurt is not so glamorous, but it will still happen. 

On a final note, last night, I watched the movie ‘Rush’ which highlights the rivalry between F1 drivers, Niki Lauda and James Hunt. In 1976, Lauda led the F1 leaderboard by some way until he suffered a near-fatal crash in the German Grand Prix. He returned to race the same season and going into the final race, despite missing 2 races that season, he was 3 points adrift of the top spot. If he won the race, he would win the F1 Driver’s Championship. Going into the final race, the rain made the track almost undrivable. In protest, Lauda retired after one lap, saying it was too dangerous. Hunt went on to become world champion. It took courage to drive that day, but it also took courage to step up and say enough is enough. 

Sometimes, pushing through is ok and it doesn’t have severe consequences. But there are also times when it’s ok not to be a ‘hero’. There is a reason your mind screams at you to stop. There is a reason that we feel pain. 

So, next time you think about playing hurt or you put someone who plays hurt on a pedestal, consider how that will impact you/them in the long-term. Consider the message you are sending regarding playing hurt for the next generation. 

Ask yourself, is it worth it? 

References:

Albert, E. (1999). Dealing with anger: The normalization of risk in cycling. International Review for the Sociology of Sport, 34, 157-171. 

Brewer, B.W., Van Raalte, J. L., & Linder, D. E. (1993). Athletic identity: Hercules’ muscles or Achilles’ heel? International Journal of Sport Psychology, 24, 237–254. 

Hughes, R.H., & Coakley, J. (1991). Positive deviance among athletes: The implications of overconformity to the sport ethic. Sociology of Sport Journal, 8, 307–325. 

Malcom, N. (2006). "Shaking it off' and "toughing it out": Socialization to pain and injury in girls' softball. Journal of Contemporary Ethnography. 35, 495-525.

McCrea M, Hammeke T, Olsen G, Leo P, & Guskiewicz K. (2004). Unreported concussion in high school football players: implications for prevention. Clin J Sport Med; 14(1): 13–17. 

Meehan W.P., Mannix R.C., O’Brien M.J., Collins M.W. (2013). The prevalence of undiagnosed concussions in athletes. Clin J Sport Med; 23(5); 339–342. 

Nixon. H. (1993). Accepting the risks of pain and injury in sport: Mediated cultural influ- ences in playing hurt. 5ocio/og>'o/5/;or/yo«rHa/, 10, 183-196.

Whatman, C., Walters, S., & Schluter, P. (2018). Coach and player attitudes to injury in youth sport. Physical Therapy in Sport, 32, 1–6.