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Optimum Performance: Playing with pain is not just for the pros

New Orleans Saints quarterback Drew Brees (9) checks on tackle Zach Strief (64) who was shaken up in the third quarter during the game between the New Orleans Saints and Carolina Panthers at the Bank of America Stadium in Charlotte on Thursday, October 30, 2014.(David Grunfeld, / The Times-Picayune) (David Grunfeld, | The Times-Picayune)

Pro athletes commonly say playing hurt is “just part of the game.” But how important is playing hurt to the ultimate success of a team like the 5-8 Saints, or for any NFL playoff-contending team?

With only three games remaining in the Saints’ regular season schedule, the Saints need all hands on deck, including their walking wounded to stay alive for a playoff berth.

Going into Week 14 against Carolina, the Saints listed the fewest of any NFL team on league injury reports. Those players included running back Travaris Cadet (hamstring), linebacker Kyle Knox (hand), running back Khiry Robinson (forearm), and running back Mark Ingram (ankle).

With the exception of Ingram, who was listed as “limited’ in practice last week, the other three players were all listed as “full participation.” And, all four were also listed as “probable” for game participation. It’s no secret tight end Jimmy Graham has played hurt most of this season, but he seems to be willing to endure his pain to try and live up to his four-year, $40-million salary.

When asked after the Carolina loss whether injuries were catching up to the Saints, Sean Payton responded, “Not buying it. I think the team we’ve played (Panthers) has gone through injuries, transitions, (and) turnovers.”

The better question would have been, “How many of your players are playing in pain and just showing up on the field?”

My other questions to Payton are:

  • Is Drew Brees still suffering from the effects of his Oblique (side) injury sustained in the preseason, which can effect his throwing motion?
  • Is Jimmy Graham still in pain from his shoulder injury- first noted on the weekly NFL injury report before the Lions game, which can affect both his receiving and blocking ability?
  • And, is Zach Strief, still in pain from his chest injury first noted before the 49ers game, which will definitely affect his ability to block?

Playing with pain in sports is certainly not limited to the professional athletes.

A recent study by Safe Kids Worldwide showed “young athletes are engaged in a dangerous culture comprised of ignoring sports injuries, and feeling pressure to play even when they’re hurt,” according to a report.

The study surveyed 3,000 athletes, coaches and parents, and found 42 percent of children said they downplayed or hid injuries so they could continue playing, 53 percent of coaches felt pressured to put injured players back into games, and almost one third of children said playing rough to send a message to the other team was normal.

In a collision sport like football, “Pain represents tissue damage,” according to Dr. Alan Kaye, Professor and Chairman of Anesthesiology at the LSU Health New Orleans, and a certified pain management specialist. Notes Kaye, “The mechanisms of pain perception starts with the inception of the injury, followed by inflammation. Then the healing process begins.”

And here is where the problem starts for the player who continues to play in pain, if he impedes the body’s healing process. “By masking the pain, as many athletes do, it can allow the injured athlete to perform at a high level,” Kaye said. “However, it could also make them vulnerable to further injury or injuries by compensating with other muscles, tendons, and ligaments.”

The NFL’s weekly injury lists are replete with players who have sustained multiple injuries during a season. “The risk,” according to Kaye (of playing hurt), “Is the potential for the extension of the initial injury and the creation of a new and more significant one.”

Such is life in the big leagues, especially when you have a losing record this late in the NFL season.

Mackie Shilstone, a regular contributor to | The Times-Picayune, has been involved in the wellness sports performance industry for nearly 40 years. He is currently the fitness coach for Serena Williams, has trained numerous other professional athletes and consulted a litany of professional sports franchises. He is St. Charles Parish Hospital’s Fitness and Wellness expert. Contact him at