Yeoman Work Prepares Athletes For Return

Athletic trainers are anonymous, until they are asked to perform miracles to get players healthy enough for the big game. Fighting Illini head trainer Al Martindale has had his share of emergencies. In this second of a three part series, he discusses his efforts to stimulate healing in athletes plus his role in treating ankle and knee injuries.

Everyone has heard stories how athletic trainers do yeoman work getting a player healthy enough to perform. This is especially reported during major basketball tournaments, when there is minimal turn-around time.

Illinois head trainer Al Martindale has had to deal with such injuries frequently, and he has been as successful as any at enhancing recovery times. Trainers are known for staying up all night with players, working on them to get them ready. Other than icing down the injury, what can a trainer do overnight?

"A lot of it depends on the individual himself. Two, it depends on the severity of the injury itself. And three, you sometimes go into your bag of tricks and see what can we do to get the swelling down. What do we have to do to get the soreness out?

"Then it goes back to communication with Coach. Maybe he's not gonna make it, that's the worst scenario. The other scenario is maybe he's not gonna practice tomorrow so that we have him for game day. A lot of it depends on how well the student-athlete reacts."

Road trips associated with tournaments require the most preparation for a trainer as he must be ready for anything.

"We take a stim unit (for electrical stimulation) with us, we take some modality with us on the trips. We take garbage buckets and fill them full of ice and water and make a slush bucket. There's other things that you can use. A lot of times, it's just doing things with your hands.

"Sometimes you bring them down to your room and have them sleep on the floor or on the bed next to you. That way you have them right there. I've done that once or twice. A lot of times, you lay there and wonder what to do next. And then it's the next hour, and you wonder what to do next.

"The tough part is trying to do something with him. He's trying to sleep, and you know sleep's important. It all comes back to the mental status of the student-athlete, being able to fight through some of that."

Perhaps Martindale's most famous exploit in basketball was helping get Luther Head ready for the Elite Eight matchup with Arizona in the 2005 NCAA Tournament. But he is quick to point out the athlete himself determines the speed of recovery.

"Luther Head strained a hamstring. Nobody thought he would play in the Arizona game. I had 3-4 days with him. We did spend a lot of time together.

"Even when we were up in Chicago getting ready, I'd wake him up at 6:30, 7:00 o'clock in the morning and take him down to the swimming pool. In essence, we did water therapy in the pool. When we came back from shootaround, we went back to the pool.

"He had his mind made up he was going to play. We did a little bit of strength work with him, and he went out and performed. But mainly he knew he was gonna play. He was up at that high level, and he performed at the max that day."

Ankle sprains require immediate ice therapy to get the swelling down. If it is a low ankle sprain, and a trainer is aggressive in his approach, many players can perform soon after the injury.

"If you get a traditional sprain in the lower part of the ankle, you're going to get swelling. It's gonna be a little more tender. Once you get the swelling down and some of the tenderness out of there, sometimes you can strap it up and tape it, put them in a brace and you may get by with it."

Some players have an instinctive need to get right up after an ankle sprain and walk on it. Unless it is severe, walking stimulates blood flow to the affected area and thus healing. It also produces endorphins that reduce pain. Others try to stay off it. A trainer helps make that decision.

"Everyone has a different philosophy of doing it. It goes back to each individual. Some people can get up and walk on it, come in and put some more tape on it, tape it a little bit different, and all of a sudden they go back out and play. Other guys may not be able to do that. It depends also on the severity of the sprain.

"Sometimes, once you get them on the sideline and back in the locker room, then all of a sudden they do start walking on it. Maybe it's not as bad as what you originally thought."

An injury that has received a great deal of attention in recent years is called a high ankle sprain. Several Illinois football players suffered that injury the last couple years, and it stayed with them the rest of the season because they kept wanting to play before it was completely healed. It can be difficult to manage.

"Those 'high ankle sprains' are very difficult to deal with. I think over time people have found the only way is, you've got to give it time to heal. The more you have somebody try to fight through it, try to play and stuff, you keep it aggravated and it doesn't get better. Then it just lingers.

"In fact, if you would have rested them for maybe two or three weeks and let it settle down and let it heal, they're gonna come back at a better percentage and be ready to play.

"They're very difficult to manage. It was seven, eight years ago, maybe longer, people termed it a 'high ankle sprain.' They kind of fooled you because you didn't have a lot of swelling. They had good motion. It didn't really bother them, but when they tried to cut, plant or jump, they just couldn't do it.

"Now with technology through MRI (Magnetic Resonance Imaging) and other scans, you get a pretty good diagnosis. 'Coach, this is what it is, this is what it's gonna take.' There's times it's difficult as an athletic trainer to go to the coach and say, 'He's gonna be out 3-4 weeks.' I don't want to hear that, but in reality that's what it's gonna be."

Another common injury among college-level athletes is torn knee ligaments. The most common of these is an Anterior Cruciate Ligament (ACL) tear. Trainers play a pivotal role, both right after the injury and after surgery to enhance healing. Doctors won't even perform surgery until certain conditions are met.

"With an ACL, there's a whole rehab protocol that you go through. When an athlete gets an ACL, the first ten days he's gonna get swelling, he's gonna have some pain and lose some range of motion.

"The thing you want to do is get that swelling out of there and get all his range of motion back, make sure he has good strength and keeps his strength up in that period of time. And then go do the surgery."

All athletes must regain their muscle strength around the knee before they will be cleared to practice and play again. Strength coaches are often sited for their work with recovering athletes. But trainers will not release an athlete to the strength coaches until the knee has sufficient range of motion and relative strength for the extra work load according to Martindale.

"After surgery, it depends on the physician and surgeon as to how fast they start motion. Some people put them in what we call a CPM machine, and the machine basically moves the knee for them.

"They may be on crutches a week to ten days, and then you ease them off the crutches and continue to work the motion. Try to start doing some light strength and conditioning exercises to get their muscle strength back.

"Eventually over weeks and months, then you start working with the strength coach. They've reached everything we can do with them in the training room. The next step is to take them to the weight room. That's why it's important that the athletic trainer and the strength coach work together real well."

In part three, Martindale discusses his fondest memories of life as an athletic trainer at Illinois. And he talks about the rewards possible for a job well done.

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